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Place this sample with your blank DEA Form 222s for quick reference. Use this sample "7-Step Checklist" (below) to ensure your form is correct before mailing.
22 Jul 2011 222 SAMPLE FORM FOR ILLUSTRATIVE PURPOSE ONLY. INSTRUCTIONS: SUPPLIERS DEA REGISTRATION No. TO BE FILLED IN BY
DEA 222 Form Sample. A copy of your current DEA license must be on file before any orders can be filled. Please send copy by fax to (501) 312-2805 or by
Sample DEA Form 222 Instruction Checklist A B C D E Name of Supplier Address City State Zoopharm 3131 Grand Ave Suite B Laramie WY 82070 Date the
20 Aug 2010 Obtain DEA 222 forms from the DEA in order to transfer or procure drug is only manufactured in one package size (Example: 1ml x 10, 50ml,
3 Jun 2013 IMPORTANT CONTROLLED SUBSTANCE DEA 222 FORM Place this sample with your blank DEA Form 222s for quick reference. Use this
No order form may be issued for Schedule I and II substances unless a Sample NDC Code Partial Qty Full Qty Manufacturer Description Strength Enter your DEA Form - 222 No., found in the bottom-left portion of the form under the.
University of Michigan. Use of Controlled Substances in Research. Sample DEA Form 222. Adapted from the Boston University Environmental Health and Safety
DEA Sample Form. To order Schedule II controlled substances from Midwest Veterinary Supply, you must have a current DEA license and a completed

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March 2018