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RTF Template

Bezirksregierung Düsseldorf

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	2019-3
2. Name of Authorisation Holder	:	Apoth. Dr. Kahlich GH
3. Address(es) of Site(s)	:	Neusser Straße 28, Krefeld, 47798, Germany

4. Legally registered address of Authorisation Holder	:	Neusser Straße 28, Krefeld, 47798, Germany
5. Scope of authorisation (complete for each site under 4)	:	ANNEX 1
6. Legal basis of authorisation	:
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2019-07-01
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: Apoth. Dr. Kahlich GH

, Neusser Straße 28, Krefeld, 47798, 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 datatechnical reasons by the Bezirksregierung Düsseldorf [District Government of Düsseldorf] in EUDRAGMDP.
Issuer of the original document and competent authority is the Kreis Wesel [County Wesel] with the responsible officer Torsten Wessel. Only for technical reasons the Bezirksregierung Düsseldorf and an officer of the Bezirksregierung Düsseldorf appear in this electronic entry. Decisive is the original document.

Diese Großhandelserlaubnis ist aus datentechnischen Gründen von der Bezirksregierung Düsseldorf in EUDRAGMDP eingetragen worden.
Aussteller der Originalurkunde und zuständige Behörde ist der Kreis Wesel mit dem ausstellenden Mitarbeiter Torsten Wessel. Lediglich aus technischen Gründen erscheint die Bezirksregierung Düsseldorf und ein Mitarbeiter der Bezirksregierung Düsseldorf in diesem elektronischen Eintrag. Maßgebend ist die Originalurkunde.

*Art 5 of Directive 2001/83/EC or Art 83 of Regulation EC/726/2004

**Without prejudice to further authorisations as may be required according to national legislation

Union Format for a Wholesale Distribution Authorisation	2019-3
	Page 1

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