Pharmacy Operation License Application PDF
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ScribdTranslationsPharmacy Operation License Application PDF
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ScribdTranslationsREPUBLIC OF PANAMA
MINISTRY OF HEALTH
NATIONAL DIRECTORATE OF PHARMACY AND DRUGS
DEPARTMENT OF QUALITY AUDITS TO ESTABLISHMENTS
PHARMACEUTICAL AND NON-PHARMACEUTICAL
SECTION OF OPERATION LICENSES FOR ESTABLISHMENTS
PHARMACEUTICAL AND NON-PHARMACEUTICAL
APPLICATION FOR PHARMACY OPERATION LICENSE
I. OWNER OR LEGAL REPRESENTATIVE INFORMATION
I, ________________________________________________ with ID No. ____________________ resident
in
profession_______________as Owner Legal Representative Representative
(BRAND LO WHAT MATCH of the establishmentpharmaceutical
denominated
I am writing to you to request for START RENEWAL Modification of the License of
Operation for the fiscal year____________. I am modifying the following:___________________________________
I hereby declare the details of the establishment.
II. DATA OF THE PHARMACEUTICAL ESTABLISHMENT AND THE MANAGER
_______________________________________________________________
Address: ____________________________________________________________
(Street or Avenue, building, premises)
_____________________
______________
Operating License number issued by the National Directorate of Pharmacy and Drugs___________________.
The pharmaceutical establishment will be dedicated to wholesale acquisition, retail sale, and dispensing.
minor pharmaceutical products through the presentation of a medical prescription. In addition to the management of
Controlled medications YES NO y will operate at the following hours:
Monday to Friday ___________________________________________________________________________
Saturdays
Sundays
Holidays
Monday to Sunday and Holidays 24 hours
The pharmaceutical regent is _______________________________________ with suitability registration ________
ID number ______________________ Fixed phone number _______________ currently residing at
Corregimiento
His teaching schedule is from Monday to Friday from __________________________________________________
________________________________________________________________________________________
Sábados
Holidays of ___________________________________(YES NO we attach the schedule rotation.
Works at another company called ___________________________________________________________
The on-duty pharmacists are (1) Lic.______________________________________Suitability___________
At the time of _____________________________________________________________
