0001796430-21-000003.txt : 20211223 0001796430-21-000003.hdr.sgml : 20211223 20211223150001 ACCESSION NUMBER: 0001796430-21-000003 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211223 DATE AS OF CHANGE: 20211223 EFFECTIVENESS DATE: 20211223 FILER: COMPANY DATA: COMPANY CONFORMED NAME: STAQ Pharma, Inc. CENTRAL INDEX KEY: 0001722397 IRS NUMBER: 364670631 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-385194 FILM NUMBER: 211516837 BUSINESS ADDRESS: STREET 1: 14135 E. 42ND AVE. STREET 2: UNIT 50 CITY: DENVER STATE: CO ZIP: 80239 BUSINESS PHONE: 720-961-2720 MAIL ADDRESS: STREET 1: 14135 E. 42ND AVE. STREET 2: UNIT 50 CITY: DENVER STATE: CO ZIP: 80239 FORMER COMPANY: FORMER CONFORMED NAME: QualMed Pharmacy, Inc. DATE OF NAME CHANGE: 20171113 D/A 1 primary_doc.xml X0708 D/A LIVE 0001722397 STAQ Pharma, Inc. 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 720-961-2720 COLORADO QualMed Pharmacy, Inc. Corporation true Joseph W Bagan 14135 E. 42ND AVE. Unit 50 Denver CO COLORADO 80239 Executive Officer Director Jeffrey L Hval 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Executive Officer Director Mark M Spiecker 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Executive Officer Director Dan Seff 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Jerrod Milton 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Scott Hawig 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Abram Gordon 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Chet Kaczor 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Steven Summer 14135 E. 42nd Ave. Unit 50 Denver CO COLORADO 80239 Director Pharmaceuticals Decline to Disclose 06b true 0001796430-21-000001 2020-12-21 true true true false 5000 60000000 30262815 29737185 false 19 0 0 0 false STAQ Pharma, Inc. /s/ Joseph W. Bagan Joseph W. Bagan Chief Executive Officer 2021-12-23