0001518913-16-000008.txt : 20161213 0001518913-16-000008.hdr.sgml : 20161213 20161213152013 ACCESSION NUMBER: 0001518913-16-000008 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161213 DATE AS OF CHANGE: 20161213 EFFECTIVENESS DATE: 20161213 FILER: COMPANY DATA: COMPANY CONFORMED NAME: DermTech, Inc. CENTRAL INDEX KEY: 0001518913 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-273021 FILM NUMBER: 162048765 BUSINESS ADDRESS: STREET 1: 11099 N. TORREY PINES ROAD STREET 2: SUITE 100 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 858-450-4222 MAIL ADDRESS: STREET 1: 11099 N. TORREY PINES ROAD STREET 2: SUITE 100 CITY: LA JOLLA STATE: CA ZIP: 92037 FORMER COMPANY: FORMER CONFORMED NAME: DermTech International DATE OF NAME CHANGE: 20110425 D/A 1 primary_doc.xml X0707 D/A LIVE 0001518913 DermTech, Inc. 11099 N. TORREY PINES ROAD SUITE 100 LA JOLLA CA CALIFORNIA 92037 858-450-4222 DELAWARE DermTech International Corporation true John Dobak, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Director Gary Jacobs c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Director Carl Peck, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Gene Salkind, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Steven Kemper c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Scott Pancoast c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Michael Willis c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Other Health Care Decline to Disclose 06b true 0001518913-16-000007 2016-10-07 false true true false 0 Paulson Investment Company LLC 5670 None None 1001 SW 5th Ave. #1460 Portland OR OREGON 97204 All States false 15512000 3119247 12392753 false 5 102797 0 0 false DermTech, Inc. /s/ John Dobak John Dobak, M.D. President & CEO 2016-12-13