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RTF Template

Food And Veterinary Service

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Veterinary medicinal products

1. Authorisation Number	:	VZL-047438/5
2. Name of Authorisation Holder	:	SIA Optimvet (ORG-100039219 / LOC-100061737)
3. Address(es) of Site(s)	:	Metru Iela 6, Grobina, Grobinas Novads, 3430, Latvia

4. Legally registered address of Authorisation Holder	:	Metru Iela 6, Grobina, 3430
5. Scope of authorisation	:	ANNEX 1
6. Legal basis of authorisation	:	Art. 65 of Directive 2001/82/EC
7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2021-11-23
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: OptimVet SIA

(ORG-100039219 / LOC-100061737)

, Metru Iela 6, Grobina, Grobinas Novads, 3430, Latvia

Veterinary medicinal products

1. MEDICINAL PRODUCTS

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

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.2. Holding

2.3. Supply

2.4. Export

Union Format for a Wholesale Distribution Authorisation	VZL-047438/5
	Page 1

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