Information Request Form

Section: Main.A1. CORP. INDEX. R-Rm.Recordati/P C2.2001. 10.01.2001. (Cardiology)
Code: 30213
Product: Italy. R
Company or Organization:
Contact's name *:
Position:
E-mail:
Mailing address:
Phone number:
Fax number:
Fields of interest: INDICATION'S
ADDRESS
LICENSEE
LICENSOR
GENERIC NAME

* If you are not linked to any company or organization complete at least this field