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RTF Template

Bezirksregierung Detmold

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	22-53-24-38.1
2. Name of Authorisation Holder	:	Ricarda Schelp
3. Address(es) of Site(s)	:	Anton-Spilker-Str. 33, Steinheim, 32839, Germany

4. Legally registered address of Authorisation Holder	:	Anton-Spilker-Str. 33, Steinheim, 32839, Germany
5. Scope of authorisation	:	ANNEX 1
6. Legal basis of authorisation	:
7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2019-02-07
10. Annexes attached	:	Annex 1 Scope of wholesale distribution authorisation Annex 2 (Optional) Address(es) of contract wholesale distribution sites and their authorisation number Annex 3 (Optional) Name(s) of responsible person(s) Annex 4 (Optional) Date of Inspection on which authorisation was granted Annex 5 (Optional) Additional provisions based on national requirements

ANNEX 1

SCOPE OF WHOLESALE DISTRIBUTION AUTHORISATION

Name and address of the site: Ricarda Schelp

, Anton-Spilker-Str. 33, Steinheim, 32839, Germany

1. MEDICINAL PRODUCTS

1.1. with a Marketing Authorisation in EEA country(s)

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.2. Holding

2.3. Supply

Any restrictions or clarifying remarks (for all users): This WDA has been registered for data-technical reasons by the Bezirksregierung Detmold [District Government of Detmold] in EUDRAGMDP. Issuer of the original document and competent authority is the Kreis Höxter [County Höxter] with the responsible officer Hans-Ulrich Solzbach. Only for technical reasons the Bezirksregierung Detmold and an officer of the Bezirksregierung Detmold appear in this electronic entry. Decisive is the original document.

Diese Großhandelserlaubnis ist aus datentechnischen Gründen von der Bezirksregierung Detmold in EUDRAGMDP eingetragen worden. Aussteller der Originalurkunde und zuständige Behörde ist der Kreis Höxter mit dem ausstellenden Mitarbeiter Hans-Ulrich Solzbach. Lediglich aus technischen Gründen erscheint die Bezirksregierung Detmold und eine Mitarbeiter der Bezirksregierung Detmold in diesem elektronischen Eintrag. Maßgebend ist die Originalurkunde.

Union Format for a Wholesale Distribution Authorisation	22-53-24-38.1
	Page 1

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