0001140361-18-021971.txt : 20180507 0001140361-18-021971.hdr.sgml : 20180507 20180507160200 ACCESSION NUMBER: 0001140361-18-021971 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180507 DATE AS OF CHANGE: 20180507 EFFECTIVENESS DATE: 20180507 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: 021-311804 FILM NUMBER: 18811205 BUSINESS ADDRESS: STREET 1: 12340 EL CAMINO REAL STREET 2: #425 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858) 223-0882 MAIL ADDRESS: STREET 1: 12340 EL CAMINO REAL STREET 2: #425 CITY: SAN DIEGO STATE: CA ZIP: 92130 D 1 primary_doc.xml X0708 D LIVE 0001632047 Dermata Therapeutics, LLC 12340 El Camino Real Suite 425 San Diego CA CALIFORNIA 92130 (858) 223-0880 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 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 Issuer Gerald T. Proehl 12340 El Camino Real Suite 425 San Diego CA CALIFORNIA 92130 Director Promoter Executive Officer Managing Member of Managing Member of Issuer Tom Insley 12340 El Camino Real Suite 425 San Diego CA CALIFORNIA 92130 Executive Officer Chief Financial Officer Chris Nardo 12340 El Camino Real Suite 425 San Diego CA CALIFORNIA 92130 Executive Officer Senior Vice President of Development Biotechnology Decline to Disclose 06b false 2016-01-01 false true false 0 Indefinite 6906244 Indefinite false 49 0 true 0 true 0 true false Dermata Therapeutics, LLC /s/ Gerald Proehl Gerald Proehl Managing Member of Managing Member of Issuer 2018-05-07