Information Request Form

Section: Main.A1. CORP. INDEX. A-Am No. 1.Altana Pharma/P.2002. 12.02.2002. GastroEntero.
Code: 39650
Product: DE. A
Company or Organization:
Contact's name *:
Position:
E-mail:
Mailing address:
Phone number:
Fax number:
Fields of interest: INDICATION'S
SALES VALUE
TRADEMARK
GENERIC NAME

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