Fusion Pharm, Inc. (FSPM)

[TraderGash]

MMs can trade pink sheet OTC shares in the premarket session. If you have a trading account that lets you direct an order to a specific MM like SpeedTrader, you can submit an order to a MM in the pre market session, but they are not obligated to take any action until the regular session opens.
You can trade OTCBB stocks in the premarket session if your broker can route through ARCA.