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31/08/2015
Request form for potential partners
Donwload  the below form and send it to the new partners dpt of Lavipharm at international@lavipharm.com.
A representative will contact you as soon as possible

Company Profile
Company Name
Company Address
Telephone
Mobile
Fax
e-mail *
Corporate website
Product/services Segments
# of years in business
Annual Turnover (€)
Employees (total)
Other
Structure
Owner
General Manager
Business Development Manager
International Marketing Manager
Current Co-operations
List of companies you currently represent
In licensing opportunities
What Lavipharm products are you interested in?
Out licensing opportunities
What products would you like to co-operate in Greece?
 





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