0001140361-15-003807.txt : 20150203 0001140361-15-003807.hdr.sgml : 20150203 20150203154026 ACCESSION NUMBER: 0001140361-15-003807 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150203 DATE AS OF CHANGE: 20150203 EFFECTIVENESS DATE: 20150203 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Dermata Therapeutics, LLC CENTRAL INDEX KEY: 0001632047 IRS NUMBER: 472638854 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-233387 FILM NUMBER: 15570802 BUSINESS ADDRESS: STREET 1: 1042-B N. EL CAMINO REAL STREET 2: SUITE 430 CITY: ENCINITAS STATE: CA ZIP: 92024 BUSINESS PHONE: (858) 756-2480 MAIL ADDRESS: STREET 1: 1042-B N. EL CAMINO REAL STREET 2: SUITE 430 CITY: ENCINITAS STATE: CA ZIP: 92024 D 1 primary_doc.xml X0707 D LIVE 0001632047 Dermata Therapeutics, LLC 1042-B N. EL CAMINO REAL SUITE 430 ENCINITAS CA CALIFORNIA 92024 (858) 756-2480 DELAWARE None None Limited Liability Company true 2014 N/A Hale BioPharma Ventures, LLC 1042-B N. El Camino Real, Ste. 430 Encinitas CA CALIFORNIA 92024 Promoter Executive Officer Managing Member of the Issuer David F. Hale 1042-B N. El Camino Real, Ste. 430 Encinitas CA CALIFORNIA 92024 Executive Officer Director Promoter Managing Member of Managing Member of the Issuer Gerald T. Proehl 1042-B N. El Camino Real, Ste. 430 Encinitas CA CALIFORNIA 92024 Director Promoter Biotechnology Decline to Disclose 06b false 2014-12-08 false true true Notes convertible into equity false 0 608050 608050 0 false 7 0 true 0 true 0 true false Dermata Therapeutics, LLC /s/ David F. Hale David F. Hale Managing Member of the Managing Member of Issuer 2015-02-03