DetifellJaya G Halaman 3 dari 36 Putusan Nomor 116/Pid.Sus/2018/PN Agm Darya 114 Daftar55 Super Tetra Varia kaplet 1000 114,000 G56 Cefixime Pharma qiotab 532 58520 DaftarLab G57 Domestrium Samco 90 tab 850 76,500 DaftarFarma G58 Penicillin Erela 200 254 50,800 Daftarkaplet Gae Dextamine Phapros 100 2230 223,000 Dattar60 Neuropyron U Harsen 90 tab 850 76,500 Datar61 Gratazon GrahaF 380 tab 249 94,620 Datar62 Pronam Harsen 70 tab 350 24500 Dalal63 Ampicillin Triniarit NV@PP@" 100 tab 590 59,000 Daftar64 Norvom

Norvom Kaplet Harsen 160 tab 380 60,800 Patar20. Gradilex 2 Graha F 120 tab 330 39,600 Datar21. Amoxicillin Novapharin 80 tab 570 45,600 Datar22. Dexaharsen 0,75 180 tab 260 46,800 Daftarmg G23. Dexaharsen 0,5 mg Harsen 220 tab 230 50,600 Patar24. Etamoxul Erita 120 tab 6,400 768,000 Datar25. Yusimox 500 mg Ifars 90 tab 1,485 133,650 Patar26. Faxiden lfars 30 tab 482 14,460 Datar27. Xicalom Solis 30 tab 300 9,000 Patar28.

Metformin 500 mg aol 50 tab 226 11,300 Daftar GDarya55 Super Tetra Varia 114 kaplet 1000 114,000 Daftar G56 Cefixime praia 110 tab 532 58,520 Daftar G57 Domestrium SBnIEO 90 tab 850 76,500 Daftar GFarma58 Penicillin Erela 200 kaplet 254 50,800 Daftar G59 Dextamine Phapros 100 2230 223,000 Daftar G60 Neuropyron U Harsen 90 tab 850 76,500 Daftar G61 Gratazon Graha F 380 tab 249 94,620 Daftar G62 Pronam Harsen 70 tab 350 24,500 Daftar G63 Ampicillin Trihidrit Nevaphan 100 tab 590 59,000 Daftar G64 Norvom

G54 Metformin 500 mg ea 50 tab 226 11,300 Daftar G55 Super Tetra Darya Varia anit 1000 114,000 Daftar G56 Cefixime Pharma Lab 110 tab 532 58,520 Daftar G57 Domestrium Samco 90 tab 850 76,500 Daftar GFarma58 Penicillin Erela 200 254 50,800 DaftarGkaplet59 Dextamine Phapros 100 2230 223,000 Daftar G60 Neuropyron U Harsen 90 tab 850 76,500 Daftar G61 Gratazon Graha F 380 tab 249 94,620 Daftar G62 Pronam Harsen 70 tab 350 24,500 Daftar G63 Ampicillin Trihidrit Novapharin 100 tab 590 59,000 Daftar G64 Norvom

Metformin 500 mg Hexparm 50 tab 226 11,300 DaftarJaya Gi Daftar55 Super Tetra Darya Varia 114 kaplet 1000 114,000 G56 Cefixime Pharma Lab 110 tab 532 58,520 Daftar57 Domestrium salnice 90 tab 850 76,500 DaftarFarma G58 Penicillin Erela 200kaplet 254 50,800 Davar98 Dextamine Phapros 100 2230 223,000 Pater60 Neuropyron U Harsen 90 tab 850 76,500 Daftar61 Gratazon Graha F 380 tab 249 94,620 Daftar62 Pronam Harsen 70 tab 350 24,500 Dattar63 Ampicillin Trihidrit Novapharin 100 tab 590 59,000 Daftar64 Norvom

untukmelakukan praktik kefarmasian sebagaimana dimaksud dalam pasal 108, yangTerdakwa lakukan antara lain dengan cara cara sebagai berikut : Bahwa pada waktu dan ditempat sebagaimana tersebut diatas, Terdakwaselaku pemilik Toko Obat NASRULLAH telah melakukan praktikkefarmasian dengan menyerahkan obat keras atau melakukan pelayananobat atas resep dokter antara lain Ketokonazole, Dexa 0,5 Haesen, RingerLaktat, D5 (Dextrose infuse), Tifestan Forte, Ampicillin, Pronicy, Gratazon,Omeroxol, Novamox, Norvom

Norvom

Ifars

Box

1

37.

Novaxicam

Novapharin

Strip

18

38.

Norvom Ifars Box 137. Novaxicam Novapharin Strip 1838. Omegtamina Mutifa Box 139. Omegzole Mutifa Box 140. Omemox Mutifa Box 141. Omemox Syrum Mutifa Botol 742. Omeprazole Errita Box 243. Omestan Mutifa Strip 1044. Ometilson Mutifa Box 245. Opistan Pertiwi Box 2 Halaman 9 dari 19 halaman Putusan Nomor 304/PID.SUS/2018/PTPBR 46. Penicillin V 50,000 Ereka Strip 1047. Planotab Pil KB Triyasa Blister 648. Prodermis Cream Ifars Tube 1249. Pronisy Kalbe Box + Strip 3+550.

Norvom Ifars Box 137. Novaxicam Novapharin Strip 1838. Omegtamina Mutifa Box 139. Omegzole Mutifa Box 140. Omemox Mutifa Box 141. Omemox Syrum Mutifa Botol 742. Omeprazole Errita Box 243. Omestan Mutifa Strip 1044. Ometilson Mutifa Box 245. Opistan Pertiwi Box 246. Penicillin V 50,000 Ereka Strip 1047. Planotab Pil KB Triyasa Blister 648. Prodermis Cream Ifars Tube 1249. Pronisy Kalbe Box + Strip 34+550. Ranitidine Holifarma Box + Sirip 3+451. Renadinac Pratapa Box 352. Rexavin Ifars Box 153.

Norvom Ifars Box 137. Novaxicam Novapharin Strip 1838. Omegtamina Mutifa Box 139. Omegzole Mutifa Box 140. Omemox Mutifa Box 141. Omemox Syrum Mutifa Botol 742. Omeprazole Errita Box 243. Omestan Mutifa Strip 1044. Ometilson Mutifa Box 245. Opistan Pertiwi Box 246. Penicillin V 50,000 Ereka Strip 1047. Planotab Pil KB Triyasa Blister 648. Prodermis Cream Ifars Tube 1249. Pronisy Kalbe Box + Strip 3+550. Ranitidine Holifarma Box + Sirip 3+451. Renadinac Pratapa Box 352. Rexavin Ifars Box 153.

Norvom 10 mg;7. Grafazol 500 mg;8. Pronam;9. Broadamox 500 mg;10. FG. Troches Meiji;11. Omeroxol;12, Solasic;13. Novachlor;14. Neoropyron V;15. Muzoral;16. Acyclovir;17. Gabiten;18. Simvastatin;19. Lexacort;20. Mexon;21. Riamycin;22. Omeprazole 20 mg;23. Renadinac 50Alofar;24. Alofar;Zo. Gludepatic 500;26. Eltazon;zi. Ciprofloxacin 500 mg;28. Farmalat 10;29.

57585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186 Helixim Sirup kering Norvom

Nama Obat Jumlah01 Helixim Sirup kering 5 (lima) botol02 Norvom Sirup kering 6 (enam) botol03 Hufacol Sirup kering 2 (dua) botol04 Mucos Drops Sirup 3 (tiga) botol05 Lerzin Drops Sirup 3 (tiga) botol06 Catezin Drops Sirup 3 (tiga) botol07 Vesperum Sirup 3 (tiga) botol08 Tivomit Sirup 3 (tiga) botol09 Etamoxul Rasa Pisang 2 (dua) botol10 Roverton Sirup 2 (dua) botol11 Microgynon 6 (enam) blister12 Pil KB Andalan 25 (dua lima) blister13 Pil KB Kombinasi 9 (Sembilan) blister14 Vosea Sirup 6 (enam) botol15

GRITIN 125 ; 11 Strip, CAPTOPRIL ; 12 Strip, NEUROPYRON V ; 5 Btl NORVOM SYRUP ; 16 Strip MOLACORT ; 7 Strip, AMBROXOL 30 ; 31 Saset, ENBATIC SERBUK ; 10 Strip, PONDEX FORTE ; 9 Biji GENDINT CREAM ; 6 Strip NIFEDIPINE ; 17 Strip DEXTEEM PLUS ; 10 Srtip, PROPANOLOL ; 24 Strip + 5 butir KALMETHASONE ; 2 Box GLIBENTAMIDE ; 5 Biji bioplacenton ; 11 Strip, LOPAMID ; 5 Biji ERLA MYCETIN ; 1 Btl YUSIMOX ; 1 Btl OMEDOM ; 5 Biji BENOSON N ; 5 Biji BETAZON N ; 5 strip, IBU PROFEN ; 8 Strip pronicy ; 13 strip

CIPROFLOXACNI ; 20 Strip + 6 tablet, VOLTADEX 50 ; 2Strip CEFADROXIL ; 9 Strip ANTALGIN ; 7 Strip NEUROMEC ; 6Strip, INFALGIN ; 8 Strip, RENADINAC ; 1 Strip, ANASTAN ; 3 Strip,MELOXICAM ; 4 Strip, OMEDRINAT ; 8 Strip, PIROXICAM ; 7 Strip.GRITIN 125 ; 11 Strip, CAPTOPRIL ; 12 Strip, NEUROPYRON V ; 5Btl NORVOM SYRUP ; 16 Strip MOLACORT ; 7 Strip, AMBROXOL 30 ;31 Saset, ENBATIC SERBUK ; 10 Strip, PONDEX FORTE ; 9 BijiGENDINT CREAM ; 6 Strip NIFEDIPINE ; 17 Strip DEXTEEM PLUS ;10 Srtip, PROPANOLOL ;

GRITIN 125 ; 11 Strip, CAPTOPRIL ; 12 Strip,NEUROPYRON V ; 5 Btl NORVOM SYRUP ; 16 Strip MOLACORT ; 7Strip, AMBROXOL 30 ; 31 Saset, ENBATIC SERBUK ; 10 Strip,PONDEX FORTE ; 9 Biji GENDINT CREAM ; 6 Strip NIFEDIPINE ; 17Strip DEXTEEM PLUS ; 10 Srtip, PROPANOLOL ; 24 Strip + 5 butirKALMETHASONE ; 2 Box GLIBENTAMIDE ; 5 Biji bioplacenton ; 11Strip, LOPAMID ; 5 Biji ERLA MYCETIN ; 1 Btl YUSIMOX ; 1 BtlOMEDOM ; 5 Biji BENOSON N ; 5 Biji BETAZON N ; 5 strip, IBUPROFEN ; 8 Strip pronicy ; 13 strip, omegtataine

GRITIN 125 ; 11 Strip, CAPTOPRIL ; 12 Strip,NEUROPYRON V ; 5 Btl NORVOM SYRUP ; 16 Strip MOLACORT ; 7 Strip,AMBROXOL 30 ; 31 Saset, ENBATIC SERBUK ; 10 Strip, PONDEX FORTE ;9 Biji GENDINT CREAM ; 6 Strip NIFEDIPINE ; 17 Strip DEXTEEM PLUS ;10 Srtip, PROPANOLOL ; 24 Strip + 5 butir KALMETHASONE ; 2 BoxGLIBENTAMIDE ; 5 Biji bioplacenton ; 11 Strip, LOPAMID ; 5 Biji ERLAMYCETIN ; 1 Btl YUSIMOX ; 1 Btl OMEDOM ; 5 Biji BENOSON N ; 5 BijiBETAZON N ; 5 strip, IBU PROFEN ; 8 Strip pronicy ; 13 strip,omegtataine

GRITIN 125 ; 11 Strip,CAPTOPRIL ; 12 Strip, NEUROPYRON V ; 5 Btl NORVOM SYRUP ;16 Strip MOLACORT ; 7 Strip, AMBROXOL 30 ; 31 Saset, ENBATICSERBUK ; 10 Strip, PONDEX FORTE ; 9 Biji GENDINT CREAM ; 6Strip NIFEDIPINE ; 17 Strip DEXTEEM PLUS ; 10 Srtip,PROPANOLOL ; 24 Strip + 5 butir KALMETHASONE ; 2 BoxGLIBENTAMIDE ; 5 Biji bioplacenton ; 11 Strip, LOPAMID ; 5 BijiERLA MYCETIN ; 1 Btl YUSIMOX ; 1 Btlh OMEDOM ; 5 BijiBENOSON N ; 5 Biji BETAZON N ; 5 strip, IBU PROFEN ; 8 Strippronicy ; 13 strip, omegtataine

tablet163 Mokbios 200 tablet164 Molacort 0,5 190 tablet165 Molasic 80 tablet166 Mucos syr 4 botol167 Mucos tab 120 tablet168 Muzoral 55 tablet169 Mycoral 80 tablet170 Mycoral Cream 14 tube171 Natrium Diklofenak 50 20 tablet172 Neuralgin 50 tablet173 Neurofiron V 20 tablet174 Nichastan 500 160 tablet175 Nifedipin 20 tablet176 Nilaren 50 80 tablet177 Nisagon Cream 18 Tube178 Nizoral cream 5 tubr179 Nizoral Tab 30 tablet180 Nofaxifen 400 100 tablet181 Norpid 10 30 tablet182 Norpid 20 30 tablet183 Norvom

No. 1177 K/Pid.Sus/2017 167 Mucos tab 120 tablet168 Muzoral 55 tablet169 Mycoral 80 tablet170 Mycoral Cream 14 tube171 Natrium Diklofenak 50 20 tablet172 Neuralgin 50 tablet173 Neurofiron V 20 tablet174 Nichastan 500 160 tablet175 Nifedipin 20 tablet176 Nilaren 50 80 tablet177 Nisagon Cream 18 Tube178 Nizoral cream 5 tubr179 Nizoral Tab 30 tablet180 Nofaxifen 400 100 tablet181 Norpid 10 30 tablet182 Norpid 20 30 tablet183 Norvom 100 tablet184 Novamox 500 80 tablet185 Novastan 500 80 tablet186 Novastan

Tablet163 Mokbios 200 Tablet164 Molacort 0,5 190 Tablet165 Molasic 80 Tablet166 Mucos syr 4 Botol167 Mucos tab 120 Tablet168 Muzoral 55 Tablet169 Mycoral 80 Tablet170 Mycoral Cream 14 Tube171 Natrium Diklofenak 50 20 Tablet172 Neuralgin 50 Tablet173 Neurofiron V 20 Tablet174 Nichastan 500 160 Tablet175 Nifedipin 20 Tablet176 Nilaren 50 80 Tablet177 Nisagon Cream 18 Tube178 Nizoral cream 5 Tubr179 Nizoral Tab 30 Tablet180 Nofaxifen 400 100 Tablet181 Norpid 10 30 Tablet182 Norpid 20 30 Tablet183 Norvom

Norvom Sirup

3 Dus

Obat Keras daftar G

71.

Amobiotic

2 Dus

Obat Keras daftar G

72.

Norvom Sirup 3 Dus om Keras daftar71. Amobiotic 2 Dus Obat Keras daftar Halaman 4 dari 34 Putusan Nomor 420/Pid.Sus/2019/PN Sim G 72. Mueos Sirup 6 Dus Obat Keras daftar73. Omeretik kapsul 1 Dus Obat Keras daftar74. Omestan 500 mg 2 Dus oa Keras daftar75. Mucos Drops 1 Dus onal Keras daftar76. Eryra DS 3 Dus Obat Keras daftar77. Mucera Sirup 3 Dus ona Keras daftar78. Mucera Drops 2 Dus Obat Keras daftar79. Dionycol 5 Dus obal Keras daftar80. Broadajoen DS 2 Dus Sua Keras daftar81.

Norvom Sirup 3 Dus Obat Keras daftarG71. Amobiotic 2 Dus Obat Keras daftarG72, Mueos Sirup 6 Dus Obat Keras daftarG73. Omeretik kapsul 1 Dus Obat Keras daftar Halaman 10 dari 34 Putusan Nomor 420/Pid.Sus/2019/PN Sim G 74. Omestan 500 mg 2 Dus Obat Keras daftarG75. Mucos Drops 1 Dus Obat Keras daftarG76. Eryra DS 3 Dus Obat Keras daftarG77. Mucera Sirup 3 Dus Obat Keras daftarG78. Mucera Drops 2 Dus Obat Keras daftarG79. Dionycol 5 Dus Obat Keras daftarG80.

Norvom Sirup 3 Dus Obat Keras daftar G71. Amobiotic 2 Dus Obat Keras daftar G72. Mueos Sirup 6 Dus Obat Keras daftar G73. Omeretik kapsul 1 Dus Obat Keras daftar G74. Omestan 500 mg 2 Dus Obat Keras daftar G75. Mucos Drops 1 Dus Obat Keras daftar G76. EryraDS 3 Dus Obat Keras daftar G77. Mucera Sirup 3 Dus Obat Keras daftar G Halaman 19 dari 34 Putusan Nomor 420/Pid.Sus/2019/PN Sim 78. Mucera Drops 2 Dus Obat Keras daftar G79. Dionycol 5 Dus Obat Keras daftar G80.

Norvom Sirup 3 Dus Obat Keras daftar G71. Amobiotic 2 Dus Obat Keras daftar G72. Mueos Sirup 6 Dus Obat Keras daftar G73. Omeretik kapsul 1 Dus Obat Keras daftar G74. Omestan 500 mg 2 Dus Obat Keras daftar G75. Mucos Drops 1 Dus Obat Keras daftar G76. EryraDS 3 Dus Obat Keras daftar G77. Mucera Sirup 3 Dus Obat Keras daftar G78. Mucera Drops 2 Dus Obat Keras daftar G79. Dionycol 5 Dus Obat Keras daftar G80. Broadajoen DS 2 Dus Obat Keras daftar G81. Metrolet Sirup 4 Dus Obat Keras daftar G82.

Norvom Sirup 3 Dus Obat Keras daftarG71. Amobiotic 2 Dus Obat Keras daftarG72. Mueos Sirup 6 Dus Obat Keras daftarG73. Omeretik kapsul 1 Dus Obat Keras daftarG74. Omestan 500 mg 2 Dus Obat Keras daftarG75. Mucos Drops 1 Dus Obat Keras daftarG76. Eryra DS 3 Dus Obat Keras daftarG77. Mucera Sirup 3 Dus Obat Keras daftarG78. Mucera Drops 2 Dus Obat Keras daftarG79. Dionycol 5 Dus Obat Keras daftarG80. Broadajoen DS 2 Dus Obat Keras daftarG81. Metrolet Sirup 4 Dus Obat Keras daftarG82.

Kimia Farma Bandung sebanyak 210 tablet, Norvom Syrup produksi PT. Ifars Pharmaceutical Lab.Solo sebanyak 2 botol, Novaxicam produksi PT. Novapharin Pharmaceutical Industries Gresik sebanyak 80 kapsul, Penicillin V produksi PT. Prafa Citeureup sebanyak 30 tablet, Pil KB I Kombinasi (Cuma-Cuma) produksi PT. Pratapa Nirmala Tangerang Indonesia sebanyak 142 blister, Pil KB I Kombinasi (Cuma-Cuma) produksi PT.

Kimia Farma Bandung sebanyak 210 tablet, Norvom Syrup produksiPT. lfars Pharmaceutical Lab.Solo sebanyak 2 botol, Novaxicam produksiPT. Novapharin Pharmaceutical Industries Gresik sebanyak 80 kapsul,Penicillin V produksi PT. Prafa Citeureup sebanyak 30 tablet, Pil KB Kombinasi (CumaCuma) produksi PT. Pratapa Nirmala TangerangIndonesia sebanyak 142 blister, Pil KB Kombinasi (CumaCuma) produksiPT. Sunthi Sepuri Tangerang Indonesia sebanyak 63 blister, Pil KB Kombinasi (CumaCuma) produksi PT.

KimiaFarma Bandung sebanyak 210 tablet, Norvom Syrup produksi PT. lfarsPharmaceutical Lab.Solo sebanyak 2 botol, Novaxicam produksi PT.Novapharin Pharmaceutical Industries Gresik sebanyak 80 kapsul, PenicillinV produksi PT. Prafa Citeureup sebanyak 30 tablet, Pil KB Kombinasi(CumaCuma) produksi PT. Pratapa Nirmala Tangerang Indonesiasebanyak 142 blister, Pil KB Kombinasi (CumaCuma) produksi PT. SunthiSepuri Tangerang Indonesia sebanyak 63 blister, Pil KB Kombinasi(CumaCuma) produksi PT.

Ifars 168 Kaplet Obat Keras Daftar G

63 Norpid 10 Graha Farma 40 Kaplet Obat Keras Daftar G

64 Norvom 10 PT. Ifars 100 kaplet Obat Keras Daftar G

65 omemox 500 PT.

Dexa Medica 6 tablet Opar eras62 Nexitra PT. lfars TGs Kaplet Opar eras63 Norpid 10 Graha Farma 40 Kaplet OPat eras64 Norvom 10 PT. Ifars 100 kaplet Opar eras65 on Tox PT. Mutifa 185 kaplet Opar erasOe eipisteilets pharmaceutieal n20 Kapiet Cafiar CG 67 Omegtamin PT. Mutifa 450 Kaptab Opa eras68 al eprazole PT. Errita Pharma 40) Kapsul Opa eras69 Oxicobal PT. lfars 70 Kapsul Opa eras70 Ometilson PT. Mutifa 180 tablet Opa eras74 Negrostan BT Nichols AO Kaplet Opa eras72 nen PT.

Ifars 168 Kaplet Oper ke eS .63 Norpid 10 Graha Farma 40 Kaplet Oper ke GC .64 Norvom 10 PT. Ifars TOO Kaplet Opa eras65 omemox 500 PT. Mutifa 185 kaplet Opa eras66 opistan 500 Pharmaceutical 20 Rep iet Daftar CG 67 Omegtamine PT. Mutifa a5G Imaplen OPar ne ce .68 Omeprazole 20 PT. Errita 40 Kapsul Obat Keras Halaman 22 dari 61 Putusan Pidana Nomor 34/Pid.Sus/2020/PN Kgn Pharma Daftar G; 70 Kapsul Obat Keras69 Oxicobal PT. lfars Daftar G; ; 140 tablet Obat Keras70 Ometilson PT.

Ifars 16s (Kaplet OPar ee GC .63 Norpid 10 Graha Farma 40 Kepler Oper ke GC .64 Norvom 10 PT. Ifars 100 kaplet Opa eras65 omemox 500 PT. Mutifa aS Naplet Opa eras66 spisian S06 Pharmanautical nfo Raper Deiter G 67 Omegtamine PT. Mutifa aed (Rapten Oper ee GC .68 Omeprazole 20 ma Erita 40 Kepsul Oper ke GC .69 Oxicobal PT. Ifars 7a Teast! OPar ne ce .70 Ometilson PT.

Ifars tes Ikaplet pate:63 Norpid 10 Graha Farma Wale pate GC .64 Norvom 10 PT. Ifars 100 kaplet OPat eras65 omemox 500 PT. Mutifa 185 kaplet Opar erase6 Spica 200 eHerManeiicel nfo Raper Dattar S 67 Omegtamine PT. Mutifa 480 Kaplan Opa eras68 Omeprazole 20 amelie 40 Kapsul Oper ke eS .69 Oxicobal PT. Ifars 70 Kapsul Opa eras70 Ometilson PT. Mutifa 1a0 Tablet Opa eras71 Nichostan 500 PT. Nicholas Wale Opa eras72 Novaxifen 400 PT.

Opa eras275 Yekapons 500 mg pr veratria 20 Tablet Opa eras276 Amlodipine besilate PT ne am 40 Tablet OPar ne eS .277 Spasminal PT Sa 20 Tablet Opar ners278 Glibenclamid 5 mg Medisharna G0 Taplet pate:279 Benostan PT Bernofarm 20 Keplet Opa ners280 FG troches meiji PT Meiji 42 Tablet OPat eras281 Norvom PT Ifars 3 Botol Opa ne = .282 Novachlor PT Novapharin a Botol Opa ere S284 Trisela PT Erela 1 Botol Opa eras285 Infatrim PT Molex Ayus 2 Bala!

Hufadine Gratia strip 643 Hufaxol Gratia botol 344 Hufralgin Gratia box 145 Irgapan 200 Dexa box 146 Lanadexon Landson box 447 Lerzin Ifars strip 348 Methyl prednisone Guardian P strip 749 Mexon Sampharindo strip 750 Microgynon bayer box 351 Microtina Pyridam kapsul 2952 Microtina - strip 153 Muzoral Molex Ayus strip 354 Muzoral Krim Mugi tube 455 Mycetin Erela botol 556 Neuralgin Kalbe strip 357 Neuromec Mecosin box 258 Neuropyron Harsen strip 559 Nilaren 50 Nicholas strip 1560 Norvom

125 Nova box 142 Hufadine Gratia strip 643 Hufaxol Gratia botol 344 Hufralgin Gratia box 145 Irqapan 200 Dexa box 146 Lanadexon Landson box 447 Lerzin fars strip 348 Methyl prednisone Guardian P strip 749 Mexon Sampharindo strip 750 Microgynon bayer box 351 Microtina Pyridam kapsul 2952 Microtina . strip 153 Muzoral Molex Ayus strip 354 Muzoral Krim Mugi tube 455 Mycetin Erela botol 556 Neuralgin Kalbe strip 357 Neuromec Mecosin box 258 Neuropyron Harsen strip 559 Nilaren 50 Nicholas strip 1560 Norvom

Gratia botol 344 Hufralgin Gratia box 145 Irgapan 200 Dexa box 146 Lanadexon Landson box47 Lerzin lfars strip Halaman 6 dari 28 Putusan Nomor 86/Pid.Sus/2017/PNPLW 48 Methyl prednisone Guardian P strip49 Mexon Sampharindo strip50 = Microgynon bayer box51 Microtina Pyridam kapsul 2952 Microtina 7 strip 153 Muzoral Molex Ayus strip 354 Muzoral Krim Mugi tube 455 Mycetin Erela botol 556 Neuralgin Kalbe strip 357 Neuromec Mecosin box 258 Neuropyron Harsen strip 559 = Nilaren 50 Nicholas strip 1560 Norvom

125 Nova box 142 Hufadine Gratia strip 643 Hufaxol Gratia botol 344 Hufralgin Gratia box 145 Irgapan 200 Dexa box 146 Lanadexon Landson box 447 Lerzin lfars strip 348 Methyl prednisone Guardian P strip 749 Mexon Sampharindo strip 750 Microgynon bayer box 351 Microtina Pyridam kapsul 2952 Microtina strip 153 Muzoral Molex Ayus strip 354 Muzoral Krim Mugi tube 455 Mycetin Erela botol 556 Neuralgin Kalbe strip 357 Neuromec Mecosin box 258 Neuropyron Harsen strip 559 Nilaren 50 Nicholas strip 1560 Norvom

Gricin 125 Nova box 142 Hufadine Gratia strip 643 Hufaxol Gratia botol 344 Hufralgin Gratia box 145 Irgapan 200 Dexa box 146 Lanadexon Landson box 447 Lerzin fars strip 348 Methyl prednisone Guardian P strip 749 Mexon Sampharindo strip 750 Microgynon bayer box 251 Microtina Pyridam kapsul 2952 Microtina strip 153 Muzoral Molex Ayus strip 354 Muzoral Krim Mugi tube 455 Mycetin Erela botol 556 Neuralgin Kalbe strip 357 Neuromec Mecosin box 258 Neuropyron Harsen strip o59 Nilaren 50 Nicholas strip 1560 Norvom

- 1 (satu) Dus @ 10x10 Norvom 10.

- 1 (satu) Dus @ 10x10 Omekur Tab.

- 4 (empat) Dus Poviral cream Kalbe.

- 2 (dua) Dus @ 10x10 Prodiabet Tab.

- 2 (dua) Dus @ 10x10 Pycameth 0,5 mg.

- 2 (dua) Dus @ 5x6 tab Redusec Tab.

- 21 (dua puluh satu) Dus @ 3x10 kap Selescardio.

- 3 (tiga) Dus @ 5x10 Sevim 20.

dua) Dus @ 10x10 Glikos 850.2 (dua) Dus @ 5x10 Glimepiride 3 mg.2 (dua) Dus @ 10x10 Gralixa 40 mg.6 (enam) Dus @ 5x10 Histigo.9 (Sembilan) Dus @ 10x10 Ifidiab.1 (Satu) Dus @ 10x10 Latibet Tab.5 (lima) Dus @ 10x10 Laveric.5 (lima) Dus @ 30 g Medscab Permetrin 5% Cream.1 (Satu) Dus @ 5x10 Metisol 4 mg.4 (empat) Dus @ 10x10 Metolon 10 mg.3 (tiga) Dus @ 5x10 Narmig 2,5 mg.7 (tujuh) Dus @ 5 ml Nelydex tetes mata.7 (tujuh) Dus @ 3x10 Norpid 10 mg.4 (empat) Dus @ 3x10 Norpid 20 mg.1 (Satu) Dus @ 10x10 Norvom

,Soneryl, Titan, Decamet 400 mg, Dilbre 30 ml, Omberzol, Laveric, Trodex,Zevask 10 mg, Glucodex, Acepress, Alodan 300 mg, Asendril, Comdipin 5mg,Decadril Injectio, Denomix krim 10 gram, Diurefo Tab, Enakur, ErladermN Krim Erela 5 g, Fargoxin 0,25 mg, Fungoral krim 2%, Genalten 5 g,Glidabet 80 mg, Glikos 850, Glimepiride 3 mg, Gralixa 40 mg, Histigo,Ifidiab, Latibet Tab, Laveric, Medscab Permetrin 5% Cream, Metisol 4 mg,Metolon 10 mg, Narmig 2,5 mg, Nelydex tetes mata, Norpid 10 mg, Norpid20 mg, Norvom

Dus @ 10x10 Glikos 850. 2 (dua) Dus @ 5x10 Glimepiride 3 mg. 2 (dua) Dus @ 10x10 Gralixa 40 mg. 6(enam) Dus @ 5x10 Histigo. 9(sembilan) Dus @ 10x10 Ifidiab. 1(satu) Dus @ 10x10 Latibet Tab. 5 (lima) Dus @ 10x10 Laveric. 5 (lima) Dus @ 30 g Medscab Permetrin 5% Cream. 1(satu) Dus @ 5x10 Metisol 4 mg. 4(empat) Dus @ 10x10 Metolon 10 mg. 3 (tiga) Dus @ 5x10 Narmig 2,5 mg. 7 (tujuh) Dus @ 5 ml Nelydex tetes mata. 7 (tujuh) Dus @ 3x10 Norpid 10 mg. 4(empat) Dus @ 3x10 Norpid 20 mg. 1(satu) Dus @ 10x10 Norvom

Tablet163 Mokbios 200 Tablet164 Molacort 0,5 190 Tablet165 Molasic 80 Tablet166 Mucos syr 4 Botol167 Mucos tab 120 Tablet168 Muzoral 55 Tablet169 Mycoral 80 Tablet170 Mycoral Cream 14 Tube171 Natrium Diklofenak 50 20 Tablet172 Neuralgin 50 Tablet173 Neurofiron V 20 Tablet174 Nichastan 500 160 Tablet175 Nifedipin 20 Tablet176 Nilaren 50 80 Tablet177 Nisagon Cream 18 Tube178 Nizoral cream 5 Tubr179 Nizoral Tab 30 Tablet180 Nofaxifen 400 100 Tablet181 Norpid 10 30 Tablet182 Norpid 20 30 Tablet183 Norvom

No. 6/PID/2017/PT.SMR 183 Norvom 100 Tablet184 Novamox 500 80 Tablet185 Novastan 500 80 Tablet186 Novastan syr 3 Botol187 Novatrim 180 Tablet188 Novaxicam 50 Tablet189 Nufadex M 180 Tablet190 Ofloxacin 40 Tablet191 Omedom syr 2 Botol192 Omedon tab 30 Tablet193 Omemox syr 5 Botol194 Omeprazol 40 Kapsul195 Omeproksil 100 Tablet196 Omeric 80 Tablet197 Omevulfin 40 Tablet198 Opistan 70 Tablet199 Oxitetraciclin Salep Mata 39 Tube200 Penicilin V 120 Tablet201 Piracetam 50 Kapsul202 Piroxicam 60 Tablet203

Antalgin tab PT.Universal strip/10 tab 56 tab Obat G41 Allopurinol tab Indo F strip/10 tab 150 tab Obat G42 Gratheos tab Graha farma strip/10 tab 750 tab Obat G43 Etamoxul tab PT.Errita strip/10 tab 500 tab Obat G44 Voltadex tab Dexa M strip/10 tab 27 tab Obat G45 Mexon Shamparindo strip/10 tab 150 tab Obat G46 Gricin tab Novapharin strip/10 tab 17 tab Obat G47 Miratrim sirup Sanpharindo btl 5 btl Obat G48 Roverton sirup PT.Ifars btl 4 btl Obat G49 Lostacef sirup Sda btl 3 btl Obat G50 Norvom

Obat Gat tab40 Antalgin tab PT.Universal strip/10 tab 56 tab Obat G41 Allopurinol Indo F strip/10 tab 150 tab Obat Gtab42 Gratheos tab Graha farma strip/10 tab 750 tab Obat G43 Etamoxul tab/PT.Errita strip/10 tab 500 tab Obat G44 Voltadex tab Dexa M strip/10 tab 27 tab Obat G45 Mexon Shamparindo strip/10 tab 150 tab Obat G46 Gricin tab Novapharin strip/10 tab 17 tab Obat G47 Miratrim Sanpharindo btl 5 btl Obat Gsirup48 Roverton PT .Ifars btl 4 btl Obat Gsirup49 Lostacef Sda btl 3 btl Obat Gsirup50 Norvom

Obat Gat tab40 Antalgin tab PT.Universal strip/10 tab 56 tab Obat G41 Allopurinol Indo F strip/10 tab 150 tab Obat Gtab42 Gratheos tab Graha farma strip/10 tab 750 tab Obat G43 Etamoxul tab/PT.Errita strip/10 tab 500 tab Obat G44 Voltadex tab Dexa M strip/10 tab 27 tab Obat G45 Mexon Shamparindo strip/10 tab 150 tab Obat G46 Gricin tab Novapharin strip/l10 tab 17 tab Obat G47 Miratrim Sanpharindo btl 5 btl Obat Gsirup48 Roverton PT Ifars btl 4 btl Obat Gsirup49 Lostacef Sda btl 3 btl Obat Gsirup50 Norvom

Norvom lfars 1 box Obat keras22. lsosorbie Dinitrat INF 2 box Obat keras23. Dexamethason Harsen 6 strip Obat keras0,524. Cefadroxil 500 Bernofarm 70 tablet Obat keras25. Ciprofloxacin 500 Novapharin 2 box Obat keras26. Solasic Solas 3 box Obat keras27. Molacort 0,5 Molex Ayus 3 box Obat keras28. Mexon Sampharindo 1 box Obat keras29. Asam Mefenamait PT. Errita Farma 2 box Obat keras50030. Amoxicillin Novapharin 1 box Obat keras31.

Norvom lfars 1 box Obat keras22. lsosorbie Dinitrat INF 2 box Obat keras23. Dexamethason Harsen 6 strip Obat keras0,524. Cefadroxil 500 Bernofarm 70 tablet Obat keras25. Ciprofloxacin 500 Novapharin 2 box Obat keras26. Solasic Solas 3 box Obat keras27. Molacort 0,5 Molex Ayus 3 box Obat keras28. Mexon Sampharindo 1 box Obat keras29. Asam Mefenamat PT. Errita Farma 2 box Obat keras50030. Amoxicillin Novapharin 1 box Obat keras31.

Farma 17 Strips25 Griseofulvin 500mg Pt Pharma Laboratories 2 Strips26 Griseofulvin 500mg Pt Mutiara Mukti Farma 10 Strips27 SultrimixDs Bernofarm Pharmaceutical 15 StripsCompany28 Acyclovir Tablet 400 Mg Sampharindo Perdana 13 StripsKardus 13KemasaNo Nama Pabrik Jmli n1 Ma Amoxcillin Solas 54 BotolKardus 14KemasaNo Nama No Reg Jumlah n1 Metformin GkI. 0608513117 al 6 Box Box2 Fenaren Dkl. 9002314616 b1 4 Box Box3 Novaxicam DkI. 0334002201 a1 15 Strip Box4 Vesperum DkI. 9909210510 a1 34 Strip Box5 Norvom

Strips25 Griseofulvin 500mg Pt Pharma Laboratories 2 Strips26 Griseofulvin 500mg Pt Mutiara Mukti Farma 10 Strips27 SultrimixDs Bernofarm 15 StripsPharmaceuticalCompany28 Acyclovir Tablet 400 Mg Sampharindo Perdana 13 StripsKardus 13No Nama Pabrik Jmli KemasanSolpenox Amoxcillin1 125 Mg Solas 54 BotolKardus 14No Nama No Reg Jumlah Kemasan1 Metformin GkI. 0608513117 a1 6 Box Box2 Fenaren Dkl. 9002314616 b1 4 Box Box3 Novaxicam DkI. 0334002201 a1 15 Strip Box4 Vesperum DkI. 9909210510 a1 34 Strip Box5 Norvom

Amoxcillin Solas 54 BotolKardus 14No Nama No Reg Jumlah Kemasan1 Metformin GkI. 0608513117 a1 6 Box Box2 Fenaren Dkl. 9002314616 b1 4 Box Box3 Novaxicam DkI. 0334002201 al 15 Strip Box4 Vesperum DkI. 9909210510 a1 34 Strip Box5 Norvom DkI. 9609205904 a1 44 Strip Box6 Lanareuma DkI. 9319604201 al 17 Strip Box7 Faxiden 20 DkI. 9609205504 b1 58 Strip Box8 Catropil 25 GkI. 0608513117 al 6 Box Box9 Zelona DklI. 1127912715 al 22 Strip Box10 Renabetic Dkl. 9231503810 al 3 Box Box11 Denicam DkI. 9306409601

UNIVERSALUNIGIN9 STRIP PHARMACEUTICAL 114ANTALGININDUSTRIESKARDUS 15 PABRIK/NEGARA JUMLA KENO NAMA SEDIAAN KEMASAN ASAL H T1 CAZETIN SIRUP Drop IFARS 8SOLPENOX2 AMOXICILIN 125 Botol SOLAS BANDUNG 25MGSAMMOXIN3 Botol SAMCO FARMA 18SIRUP KERINGNOVATRIM NOVAPHARN4 Botol 14SUSPENSI PHARMACEUTICAL5 NORVOM SIRUP Botol IFARS 11KLORFESON6 Tube MOLEX AYUS 25KRIM7 BIOPLACENTON Tube KALBE FARMA 38 Halaman 8 dari 91 Putusan Nomor 135/Pid.Sus/2020/PN Plj 8 OVISKINN KRIM Tube KALBE FARMA 10ACYCLOVIR FIRST9 Tube

JUMLA KENO NAMA SEDIAAN KEMASANASAL H T1 Yusimox Botol Ifars 412 Helixim Botol Ifars 163 Omeroxol Botol Mutiara Mukti Farma 164 Lostacef Botol Ifars 65 Lerzim Botol Ifars 86 Vesperum Botol Ifars 87 Roverton Botol Ifars 12KARDUS 22PABRIK/NEGARA JUMLA KENO NAMA SEDIAAN KEMASANASAL H T1 Andalan Pil KB Blister Harsen 902 Solpenox Botol Solas 163 Novatrim Botol Novapharin 114 Lostacef Botol Ifars 65 Roverton Botol Ifars 86 Lerzin Botol Ifars 127 Sammoxin Botol PT Samco Farma 288 Helixim Botol Ifars 29 Norvom

UNIVERSAL9 UNIGIN ANTALGIN STRIP PHARMACEUTICAL 114INDUSTRIESKARDUS 15NO NAMA SEDIAAN KEMASAN PABRIK/NEGARA ASAL JUMLAH KET1 CAZETIN SIRUP Drop IFARS 8SOLPENOX2 Botol SOLAS BANDUNG 25AMOXICILIN 125 MGSAMMOXIN SIRUP3 Botol SAMCO FARMA 18KERINGNOVATRIM NOVAPHARN4 Botol 14SUSPENSI PHARMACEUTICAL5 NORVOM SIRUP Botol IFARS 116 KLORFESON KRIM Tube MOLEX AYUS 257 BIOPLACENTON Tube KALBE FARMA 388 OVISKINN KRIM Tube KALBE FARMA 10ACYCLOVIR KRIM 59 8g Tube FIRST MEDIPHARMA 31(0)10 NISAGON G KRIM Tube IFARS

STRIP 17SERANGINDONESIAPT MULIA FARMA SUCI8 SIMVASTATIN 20MG STRIP 9SERANGINDONESIAPT IFARS9 NORVOM 10 MG STRIP 63PHARMACEUTICALPT ERRITA PHARMA10 ETAFEN 400 STRIP 30BANDUNG INDONESIANOVAPHARIN11 NOVAXIFEN 400 STRIP PHARMACEUTICAL 38INDUSTRIESOMEDOM PT. MUTIFA MEDAN12 STRIP 29DOMPERIDONE INDONESIAALLOPURINOL 100 PT.

UNIVERSAL9 UNIGIN ANTALGIN STRIP PHARMACEUTICAL 114INDUSTRIESKARDUS 15NO NAMA SEDIAAN KEMASAN PABRIK/NEGARA ASAL JUMLAH KET1 CAZETIN SIRUP Drop IFARS 8SOLPENOX Botol SOLAS BANDUNG 25 Halaman 64 dari 91 Putusan Nomor 135/Pid.Sus/2020/PN PIj AMOXICILIN 125 MGSAMMOXIN SIRUP3 Botol SAMCO FARMA 18KERINGNOVATRIM NOVAPHARN4 Botol 14SUSPENSI PHARMACEUTICAL5 NORVOM SIRUP Botol IFARS 116 KLORFESON KRIM Tube MOLEX AYUS 257 BIOPLACENTON Tube KALBE FARMA 388 OVISKINN KRIM Tube KALBE FARMA 10ACYCLOVIR KRIM 59

Grafalin 4 32 Box Graha Farma Obat Keras- Histapan 31 Box Sanbe Obat Keras- Salbutamol 16 Box First Obat Keras- Zoline 14 Box Pyridam Obat Keras- Fenamin 48 Box Zenith Obat Keras- Amosterra 82 Box Sejahtera Lestari Obat Keras- Vadrol 73 Box Novapharin Obat Keras- Ampicillin 500 17 Box Pharmalaboratorium Obat Keras- Amoxicillin 500 21 Box Pharmalaboratorium Obat Keras- Zoralin krim 84 Tube Medicon Obat Keras- Polofar plus 45 Box Ifars Obat Keras- Isosorbide dinitrat 31 Box INF Obat Keras- Norvom

Grafalin 4 32 Box Graha Farma Obat Keras23 Histapan 31 Box Sanbe Obat Keras24 Salbutamol 16 Box First Obat Keras25 Zoline 14 Box Pyridam Obat Keras26 Fenamin 48 Box Zenith Obat Keras27 Amosterra 82 Box Sejahtera Lestari Obat Keras28 Vadrol 73 Box Novapharin Obat Keras29 Ampicillin 500 17 Box Pharmalaboratorium Obat Keras30 Amoxicillin 500 21 Box Pharmalaboratorium Obat Keras31 Zoralin krim 84 Tube Medicon Obat Keras32 Polofar plus 45 Box lfars Obat Keras33 Isosorbide dinitrat 31 Box INF Obat Keras34 Norvom

Norvom 32 Box lfars Obat Keras35. Tifestan forte 14 Box Balatif Obat Keras36. Asam Mefenamat 35 Box Promedraharjo Obat Keras37. Toxaprim 42 Box Samco farma Obat Keras38. Hidrocortison krim 168 tube Kimia Farma Obat Keras39. Asam Mefenamat 4 Box Indo farma Obat Keras40. Acyclovir 7 Box Indo Farma Obat Keras41. Planotab 10 Box Triyasa Nagamas Obat Keras42. Zemoxil 500 3 Box Zenith Obat Keras43. Dolodon 500 10 Box Mecosin Obat Keras44. Fimestan Forte 32 Box First Obat Keras45.

PN Sak 33 Hufadine Graha Farma 9 Strip34 Inflason Brelico 9 Strip35 Kaldexon 0,5 Promed 8 Strip36 Kalmethasone Kalbe 18 Strip37 Lerzin lfars 19 Strip38 Lexacort Molex Ayus 4 Strip39 Licodexon Berlico 16 Strip40 Lopadium Zenith 4 Strip41 Loratadine 10 mg Indofarma 4 Strip42 Mexon Sampharindo 5 Strip43 Midix Itrasal 4 Strip44 Muzoral Molex 3 Strip45 Muzoral 200 mg Molex Ayus 4 Box46 Mycoral tablat Kalbe 2 Strip47 Neuralgin Kalbe 2 Strip48 Nichostan 500 Nicholas 4 Tablet49 Nizoral Medikon 8 Strip50 Norvom

untuk melakukan praktik kefarmasiansebagaimana dimaksud dalam Pasal 108, yang Terdakwa lakukan antara laindengan caracara sebagai berikut: Bahwa pada waktu dan di tempat sebagaimana tersebut di atas, Terdakwaselaku pemilik Toko Obat NASRULLAH telah melakukan praktik kefarmasiandengan menyerahkan obat keras atau melakukan pelayanan obat atas resepdokter antara lain Ketokonazole, Dexa 0,5 Haesen, Ringer Laktat, D5(Dextrose infuse), Tifestan Forte, Ampicillin, Pronicy, Gratazon, Omeroxol,Novamox, Norvom