ANNEX IIISupplementary provisions
ANNEX III Notification to the European Commission of medicinal products not subject to prescription judged to be at risk of falsification , pursuant to article 54a(4) of Directive 2001/83/EC Member State: Name of competent authority: Entry No Active substance (Common Name) Pharmaceutical form Strength Anatomical Therapeutical Chemical (ATC) Code Supporting Evidence (please provide evidence of one or more incidents of falsification in the legal supply chain and specify the source of the information). 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Note: The number of entries is not binding.