Указ Губернатора Орловской области от 30.10.2012 № 441

|         | государственной пошлины       |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
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|   10.   | __* изменением перечня выполняемых работ, оказываемых услуг, составляющих лицензируемый вид деятельности, ранее не указанных в лицензии                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |
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|  10.1.  | Сведения о новых работах      | 2. Аптечные организации:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|         | (услугах), которые лицензиат  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | намерен выполнять при         | 2.1. Аптека готовых лекарственных форм                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|         | осуществлении                 | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         | фармацевтической деятельности |                                                                                                                                                                                                                                                                                               (адрес места осуществления фармацевтической деятельности)                                                                                                                                                                                                                                                                                                |
|         | в сфере обращения             | 2.2. Аптека производственная                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |
|         | лекарственных средств для     | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         | медицинского применения.      |                                                                                                                                                                                                                                                                                               (адрес места осуществления фармацевтической деятельности)                                                                                                                                                                                                                                                                                                |
|         | Адрес(а) места осуществления  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | лицензируемого вида           | 2.3. Аптека производственная с правом изготовления асептических лекарственных препаратов                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|         | деятельности                  | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                               (адрес места осуществления фармацевтической деятельности)                                                                                                                                                                                                                                                                                                |
|         |                               | 2.4. Аптечный пункт                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                                          ___________________________________                                                                                                                                                                                                                                                                                                           |
|         |                               |                                                                                                                                                                                                                                                                                              (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                                              |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 2.5. Аптечный киоск                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                              (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                                              |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         |                               | __* перевозка лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | __* перевозка лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* розничная торговля лекарственными препаратами для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
|         |                               | __* отпуск лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* изготовление лекарственных препаратов для медицинского применения.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 3. Структурные подразделения медицинских организаций:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 3.1. Аптека готовых лекарственных форм                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 3.2. Аптека производственная                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |
|         |                               | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                               (адрес места осуществления фармацевтической деятельности)                                                                                                                                                                                                                                                                                                |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 3.3. Аптека производственная с правом изготовления асептических лекарственных препаратов                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
|         |                               | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                               (адрес места осуществления фармацевтической деятельности)                                                                                                                                                                                                                                                                                                |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 3.4. Аптечный пункт                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | ___________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                                              (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                                              |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         |                               | __* перевозка лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | __* перевозка лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* розничная торговля лекарственными препаратами для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
|         |                               | __* отпуск лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* изготовление лекарственных препаратов для медицинского применения.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 4. Обособленные подразделения медицинских организаций, расположенных в сельских поселениях, в которых отсутствуют аптечные организации:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 4.1. Центр (отделение) общей врачебной (семейной) практики                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               | 4.2. Амбулатория                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 4.3. Фельдшерский пункт                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               | 4.4. Фельдшерско-акушерский пункт                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         |                               | __* перевозка лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | __* розничная торговля лекарственными препаратами для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
|         |                               | __* отпуск лекарственных препаратов для медицинского применения.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | 5. Индивидуальные предприниматели                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         |                               | __* перевозка лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | __* перевозка лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* розничная торговля лекарственными препаратами для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
|         |                               | __* отпуск лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* изготовление лекарственных препаратов для медицинского применения.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|—————————|———————————————————————————————|————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————|
|         |                               | 6. Иные организации, осуществляющие обращение лекарственных средств                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               |                                                                                                                                                                                                                                                                            ___________________________________ (адрес места осуществления лицензируемого вида деятельности)                                                                                                                                                                                                                                                                            |
|         |                               |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         |                               | __* хранение лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         |                               | __* перевозка лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         |                               | __* перевозка лекарственных средств для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* розничная торговля лекарственными препаратами для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
|         |                               | __* отпуск лекарственных препаратов для медицинского применения;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       |
|         |                               | __* изготовление лекарственных препаратов для медицинского применения                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |
|—————————|———————————————————————————————|————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————|
|  10.2.  | Сведения о наличии высшего    | Реквизиты документов о высшем или среднем фармацевтическом образовании и сертификатов специалистов                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
|         | или среднего                  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | фармацевтического образования |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | и сертификатов специалистов - |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | для работников, намеренных    |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | выполнять (осуществлять)      |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | новые работы (услуги) (в      |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | случае намерения осуществлять |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | перевозку лекарственных       |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | средств для медицинского      |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | применения данные сведения не |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | указываются)                  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|—————————|———————————————————————————————|————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————|
|  10.3.  | Сведения о наличии            | Наименование, тип оборудования и реквизиты документов, подтверждающих право собственности или иное законное основание использования оборудования для осуществления фармацевтической деятельности:                                                                                                                                                                                                                                                                                                                                                                                                                                                      |
|         | необходимого оборудования,    |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | соответствующего              |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | установленным требованиям     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | (в случае намерения           |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | осуществлять перевозку        |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | лекарственных средств для     |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | медицинского применения       |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | данные сведения не            |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | указываются)                  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|—————————|———————————————————————————————|————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————|
|  10.4.  | Сведения о наличии            | Реквизиты санитарно-эпидемиологического заключения:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |
|         | санитарно-эпидемиологического | __________________________________________________________________________________________________________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
|         | заключения о соответствии     |                                                                                                                                                                                                                                                                                        (дата и N санитарно-эпидемиологического заключения, N бланка заключения)                                                                                                                                                                                                                                                                                        |
|         | помещений, предназначенных    |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |
|         | для выполнения                |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |