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RTF Template

District Government Muenster

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_NW_RE_WDA_2019_0003/53/5_S_93/19
2. Name of Authorisation Holder	:	Felix Holzwarth
3. Address(es) of Site(s)	:	Am Güterbahnhof 14, Dorsten, 46284, Germany

4. Legally registered address of Authorisation Holder	:	Am Güterbahnhof 14, Dorsten, 46284, 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	:	2019-07-15
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: Felix Holzwarth

, Am Güterbahnhof 14, Dorsten, 46284, 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 Muenster [District Government of Muenster] in EUDRAGMDP. Issuer of the original document and competent authority is the County Recklinghausen with the responsible officer Hanneline Lochte. Only for technical reasons the Bezirksregierung Muenster and an officer of the Bezirksregierung Muenster appear in this electronic entry. Decisive is the original document.

Diese Großhandelserlaubnis ist aus datentechnischen Gründen von der Bezirksregierung Münster in
EUDRAGMDP eingetragen worden. Aussteller der Originalurkunde und zuständige Behörde ist der Kreis Recklinghausen mit der ausstellenden Mitarbeiterin Hanneline Lochte. Lediglich aus technischen Gründen erscheint die Bezirksregierung Münster und ein Mitarbeiter der Bezirksregierung Münster in diesem elektronischen Eintrag. Maßgebend ist die Originalurkunde.

Union Format for a Wholesale Distribution Authorisation	DE_NW_RE_WDA_2019_0003/53/5_S_93/19
	Page 1

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