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In Licensing Opportunity Submission Form
Title :
Mr. Ms.   Dr.
First Name :
Last Name :
Designation :
Company :
Annual Turnover :
Address :
City :
Postal Code :
E mail :

Telephone :

Fax :
Website :
Nature Of your offering
New Chemical Entity
Low Molecular Wt. Compound
Defined Natural Product
Other Protein
Drug Delivery System
Controlled release Systems
Biorhythm based delivery systems
Targeted vesicular systems
Mucoadhesive nanoparticles
Taste Masking
Osmotically controlled DDS
Gastroretentive systems
Pulmonary DDS
Transdermal Drug Delivery System
Biodegradable DDS
Monoclonal Antibody DDS
Polymer/membrane DDS
Liposome Delivered DDS
Diffusion Delivery System
Prodrug Delivered Drug
Coatings Delivery System
Magnetic Targeted Carriers Delivered Drug
Site Selective DDS
Transmucosal DDS
Buccal Delivery System
Microencapulated DDS
Vaginal Delivery System
Patch Delivery System
Occular Delivery System
Pegnology DDS
Rectal Delivery System
Monolithic Dispersion DDS
Erosion DDS
Name of Vaccine
Other Information
Natural Product
Active Ingredient
Source Plant
Other Information
Related Information
Pulmonary Drug Delivery devices
Transdermal Drug Delivery devices
Non Invasive Injectable device
Artery cath drill
Diagnostic Devices
Skin Contact Adhesive
Is your offering patented?
Yes No
If yes, please provide details:
Patent No. Patent Type Date of Expiry


Sr No. Edit Delete Country Patent No Patent Type Expiry Date
Are you the inventor or co-inventor?
Yes No
What is the molecular target of your offering?
Labeled indication you are offering for your product:
Are all indications available for licensing?
Yes No.
If not, please indicate which indications are excluded:
What is the potency of the compound in relevant in vitro assays?
  [max 50 words]
What is the potency of the compound when given to animals? (Mention type of administration.)
  [max 50 words]
Is toxicological data available?
Is clinical data available?
Yes,  No
If yes, at what phase:
Phase 1 Phase 2 Phase 3 Phase 4
ADR Profile:
  [max 50 words]
Any Death Reported?
Yes.  No
If yes, please provide details:
Other Details