0001567619-20-020866.txt : 20201210 0001567619-20-020866.hdr.sgml : 20201210 20201210164701 ACCESSION NUMBER: 0001567619-20-020866 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201210 DATE AS OF CHANGE: 20201210 EFFECTIVENESS DATE: 20201210 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: 021-382898 FILM NUMBER: 201381153 BUSINESS ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 BUSINESS PHONE: (858) 223-0882 MAIL ADDRESS: STREET 1: 3525 DEL MAR HEIGHTS RD., #322 CITY: SAN DIEGO STATE: CA ZIP: 92130 D 1 primary_doc.xml X0708 D LIVE 0001632047 Dermata Therapeutics, LLC 3525 Del Mar Heights Rd Suite 322 San Diego CA CALIFORNIA 92130 (858) 223-0880 DELAWARE None None Limited Liability Company true 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 3525 Del Mar Heights Rd Suite 322 San Diego CA CALIFORNIA 92130 Director Promoter Executive Officer Managing Member of Managing Member of Issuer Tom Insley 3525 Del Mar Heights Rd Suite 322 San Diego CA CALIFORNIA 92130 Executive Officer Chief Financial Officer Chris Nardo 3525 Del Mar Heights Rd Suite 322 San Diego CA CALIFORNIA 92130 Executive Officer Senior Vice President of Development Wendell Wierenga 3525 Del Mar Heights Rd., hts Rd Suite 322 San Diego CA CALIFORNIA 92130 Director Biotechnology Decline to Disclose 06b false 2020-07-17 false true false 0 Indefinite 3000000 Indefinite false 37 0 true 0 true 0 true false Dermata Therapeutics, LLC /s/ Gerald Proehl Gerald Proehl Managing Member of Managing Member of Issuer 2020-12-09