0001516068-20-000004.txt : 20201221 0001516068-20-000004.hdr.sgml : 20201221 20201221085228 ACCESSION NUMBER: 0001516068-20-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201221 DATE AS OF CHANGE: 20201221 EFFECTIVENESS DATE: 20201221 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Avisa Pharma Inc. CENTRAL INDEX KEY: 0001516068 IRS NUMBER: 273584660 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-383797 FILM NUMBER: 201402545 BUSINESS ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 BUSINESS PHONE: 505-820-1400 MAIL ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 D 1 primary_doc.xml X0708 D LIVE 0001516068 Avisa Pharma Inc. 1660A OLD PECOS TRAIL SANTA FE NM NEW MEXICO 87505 505-820-1400 DELAWARE None None Corporation true David S. Joseph 1660A Old Pecos Trail Sante Fe NM NEW MEXICO 87505 Executive Officer Director J. Chuck Morrison 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Brian P. Birk 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director William A. Miller 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Thomas R. Morse 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Matt Culler 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Executive Officer Other Health Care Decline to Disclose 06b false 2020-12-04 false true false 0 200000 200000 0 false 6 0 0 0 false Avisa Pharma Inc. David S. Joseph David S. Joseph CEO and President 2020-12-21