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RTF Template

State Medicines Control Agency under the Ministry of Health of the Republic of Lithuania

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	0941
2. Name of Authorisation Holder	:	Lietuvos ir Suomijos uždaroji akcinė bendrovė "Plandent"
3. Address(es) of Site(s)	:	Gedimino g. 15-12, Kauno miesto sav., Kauno m., LT-44318, Lithuania

4. Legally registered address of Authorisation Holder	:	Gedimino g. 15, Kauno miesto sav., Kauno m., LT-44318, Lithuania
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	:	2021-10-15
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: Lietuvos ir Suomijos UAB "Plandent"

, Gedimino g. 15-12, Kauno miesto sav., Kauno m., LT-44318, Lithuania

1. MEDICINAL PRODUCTS

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

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.3. Supply

Any restrictions or clarifying remarks (for all users): 2021-06-23 Agreement on warehousing No.LIM-SUT-918/2021 with UAB "LIMEDIKA", Erdvės g.51, Ramučių k., Karmėlavos sen., Kauno r. sav., Lithuania (Wholesale distribution authorisation No.0112). Wholesale distribution operations performed according to the Agreement: holding (warehousing).
2021-06-23 sandėliavimo sutartis Nr.LIM-SUT-918/2021 su UAB "LIMEDIKA", Erdvės g.51, Ramučių k., Karmėlavos sen., Kauno r. sav. (Didmeninio platinimo licencija Nr.0112). Pagal sutartį vykdomi didmeninio platinimo veiksmai: laikymas (saugojimas).

*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	0941
	Page 1

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