Mailing Address
Springfield Office: 320 West Washington St
Springfield, IL 62786
Chicago Office: James R. Thompson Ctr
100 W. Randolph St
Suite 9-300
Chicago, IL 60601
Telephone
Springfield Office:
(217)785-0800
(217)524-6735 TDD
(217)782-7645FAX
Chicago: (312)814-4500
(217)782-3414 For Real Estate Calls
WHOLESALE DRUG DISTRIBUTOR &
097 OTHER CONTROLLED SUBSTANCE LICENSEES
NOTE: PRINT USING BLACK INK ON WHITE PAPER.
COMPLETE THE APPLICATION AND MAIL ALL PAGES
PARTIAL APPLICATIONS WILL NOT BE PROCESSED
Acrobat Reader 5.0 and above is necessary to
access PDF documents.
CLICK ON the "Get Acrobat
Reader" icon to download the product free.
Wholesale Drug DistributorTHIS PACKET INCLUDES:
. Instruction Sheet
. Application for Licensure as an Illinois In-State Drug Distributor
. Application for Licensure as an Illinois Out-of-State Drug Distributor
. CT Drug Distributor Certification by Licensing Agency/Board
. Instructions for Controlled Substances Application
. Application for Licensure under the Illinois Controlled Substances Act
097 Other Controlled Substance LicenseesTHIS PACKET INCLUDES:
. Instructions and Application for Controlled Substances Act
THE CONTENTS OF THIS PACKET APPLIES TO:
Research and/or Teaching
Chemical Analysis (Analytical Laboratory)
Instructional Activity/Universities/Colleges
Surgical Center/Ambulatory Care
Clinics
Animal Shelters/Dog Training