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LOA Request
DMF HOLDER'S INFORMATION
DMF Number / Destination
US - 28585
CN - B20190000208
CA - 2017-147
Regulatory agency
US - FDA
CN - NMPA
CA - Health Canada
DMF holder’s name
Subject (Title)
US - PLASTIC INJECTION MOLDED CLOSURE SYSTEM
CN - RayDyLyo CTO 小瓶压盖
CA - PLASTIC INJECTION MOLDED CLOSURE SYSTEM
ARaymondlife’s product description or category number (include size, color)
REQUESTER’S CONTACT
First name
Last name
Function
Phone Number
Email Address
AUTHORIZED PARTY’S INFORMATION
Company / Institution Name
Street address
City
State / Province
Postal Code
Country
REGULATORY AFFAIRS' CONTACT (if different from requester)
First name
Last name
Function
Phone Number
Email Address
PRODUCTS APPLICATION DETAILS
Drug product name or code
Drug category
Application type
Application number
OTHERS
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