|
Delaware
(State or other jurisdiction of
incorporation or organization) |
| |
11-3363609
(I.R.S. Employer
Identification No.) |
|
|
Large accelerated filer
☒
|
| |
Accelerated filer
☐
|
|
|
Non-accelerated filer
☐
|
| |
Smaller reporting company
☐
|
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| | | |
Emerging growth company
☐
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SEC registration fee
|
| | | $ | 33,060 | | |
|
Legal fees and expenses
|
| | | $ | * | | |
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Accounting fees and expenses
|
| | | $ | * | | |
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Miscellaneous
|
| | | $ | * | | |
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Total
|
| | | $ | * | | |
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Exhibit No.
|
| |
Description
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|
| 1.1* | | | Form of Underwriting Agreement | |
| 3.1 | | | | |
| 3.2 | | | | |
| 4.1* | | | Form of Common Stock Warrant Agreement and Warrant Certificate | |
| 4.2* | | | Form of Debt Securities Warrant Agreement and Warrant Certificate | |
| 4.3+ | | | | |
| 4.4+ | | | | |
| 4.5* | | | Form of Senior Note | |
| 4.6* | | | Form of Subordinated Note | |
| 4.7* | | | Form of Rights Agreement and Rights Certificate | |
| 5.1+ | | | | |
| 23.1+ | | | | |
| 23.2+ | | | | |
| 24.1+ | | | | |
| 25.1** | | | Form T-1 Statement of Eligibility of Trustee | |
| 107+ | | | |
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Signature
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Title
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/s/ Thomas T. Vo, M.D.
Thomas T. Vo, M.D.
|
| | Chief Executive Officer and Chairman of the Board (principal executive officer) | |
|
/s/ Jon C. Bates
Jon C. Bates
|
| | Chief Financial Officer (principal financial officer and principal accounting officer) | |
|
/s/ Warren Hosseinion
Warren Hosseinion
|
| | President and Director | |
|
/s/ Matthew S. Young, M.D.
Matthew S. Young, M.D.
|
| | Director | |
|
/s/ John Waters, CPA
John Waters, CPA
|
| | Director | |
|
/s/ Cheryl Grenas, R.N., M.S.N.
Cheryl Grenas, R.N., M.S.N.
|
| | Director | |
|
/s/ Michael L. Reed
Michael L. Reed
|
| | Director | |
|
/s/ Mitchell Creem
Mitchell Creem
|
| | Director | |