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LICATION FOR LICENSING OF VETERINARY DRUG AND PRODUCT ESTABLISHMENTS (Under R.A. 1556 - The Livestock and Poultry Feeds Act) Date Name of Company/Establishment : Office Address : Nature of Business : (VDAP Manufacturer/VDAP Trader/VDAP Distributor/Importer/VDAP Wholesaler/VDAP Exporter/VDAP Oulet) Tel No. : Fax No. : e-mail address : Business Organization : Sole Proprietorship/Partnership/Corporation/Others (Specify) Plant/Store Address : Tel No. : No. of Warehouse (s) : Address : Labo.

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