Form to apply for export authorisation under the royal decree of 19 January 2023 implementing article 12septies, second paragraph, of the Law of 25 March 1964 on medicines Name of medicine Dosage Pharmaceutical form Marketing authorisation holder Authorisation number CTI-ext CNK Number of packages intended for export Wholesaler (distributor) Name of contact person E-mail address of contact person Contact phone number Additional information More information or problems completing this form? Contact supply-problems@fagg-afmps.be
Your medicine and health products
Your medicine and health products