0001209191-11-035279.txt : 20110617
0001209191-11-035279.hdr.sgml : 20110617
20110617162709
ACCESSION NUMBER: 0001209191-11-035279
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110615
FILED AS OF DATE: 20110617
DATE AS OF CHANGE: 20110617
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CARRIERO EDWARD M JR
CENTRAL INDEX KEY: 0001382262
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34171
FILM NUMBER: 11918730
MAIL ADDRESS:
STREET 1: 595 SOUTH FEDERAL HIGHWAY
STREET 2: SUITE 500
CITY: BOCA RATON
STATE: FL
ZIP: 33432
FORMER NAME:
FORMER CONFORMED NAME: CARRIERO EDWARD
DATE OF NAME CHANGE: 20061129
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Graymark Healthcare, Inc.
CENTRAL INDEX KEY: 0001272597
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093]
IRS NUMBER: 200180812
STATE OF INCORPORATION: OK
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 101 N. ROBINSON
STREET 2: SUITE 920
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73102
BUSINESS PHONE: 4056015300
MAIL ADDRESS:
STREET 1: 101 N. ROBINSON
STREET 2: SUITE 920
CITY: OKLAHOMA CITY
STATE: OK
ZIP: 73102
FORMER COMPANY:
FORMER CONFORMED NAME: GRAYMARK PRODUCTIONS INC
DATE OF NAME CHANGE: 20031210
4
1
c18896_4x0.xml
MAIN DOCUMENT DESCRIPTION
X0303
4
2011-06-15
0001272597
Graymark Healthcare, Inc.
GRMH
0001382262
CARRIERO EDWARD M JR
210 PARK AVENUE
SUITE 1350
OKLAHOMA CITY
OK
73102
0
1
0
0
Chief Financial Officer
Common Stock
2011-06-15
4
P
0
72000
A
72000
I
By wife
Common Stock Warrants (right to buy)
1.50
2011-06-15
4
P
0
72000
A
2011-06-20
2016-06-20
Common Stock
72000
72000
I
By wife
Each share of common stock was purchased together with a warrant to purchase one share of common stock at a public offering price of $1.40 per combination.
/s/ Meredith Tipton, by power of attorney
2011-06-17