Clinic License Application {17A-68} | Pdf Fpdf Docx | California

 California   Statewide   Board Of Pharmacy 
Clinic License Application {17A-68} | Pdf Fpdf Docx | California

Last updated: 3/5/2020

Clinic License Application {17A-68}

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Description

17A-68, CALIFORNIA WHOLESALER LICENSE APPLICATION, Complete the entire application and submit with original signatures. • Do Not Leave Blanks: If an item or question is not applicable, indicate N/A. • Doing Business As (DBA): If using a DBA, submit a completed Fictitious Business Name Statement that has been certified by the Office of the County Clerk in the county in which it was filed. www.FormsWorkflow.com

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