Chief Pharmaceutical Inspectorate
UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION
1. Authorisation Number
:
GIF-N-411/1084/1-11/TL/15
2. Name of Authorisation Holder
ZIELONEWAPLEWO sp. z o.o.
3. Address(es) of Site(s)
16, Słuszczyn, MAZOWIECKIE, 27-320, Poland
4. Legally registered address of Authorisation Holder
42, Waplewo, WARMIŃSKO-MAZURSKIE, 11-015, Poland
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
2016-09-16
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
SCOPE OF WHOLESALE DISTRIBUTION AUTHORISATION
Name and address of the site: Hurtownia farmaceutyczna
, 16, Słuszczyn, MAZOWIECKIE, 27-320, Poland
1.1. with a Marketing Authorisation in EEA country(s)
1.2. without a Marketing Authorisation in the EEA and intended for EEA market
1.3. without a Marketing Authorisation in the EEA and intended for exportation
2.1. Procurement
2.2. Holding
2.4. Export
3.4. Other products: 3.4.6
Reason for Withdrawing:
This WDA is no longer valid. It has been was withdrawn by decision of the competent authority.
To zezwolenie nie jest już aktualne. Zostało wycofane decyzją organu kompetentnego.
Union Format for a Wholesale Distribution Authorisation
Page 1
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