CONTROLLED SUBSTANCES Inventory Log - NCBOP
CONTROLLED SUBSTANCES Inventory Log Name of PHARMACY Name of REGISTRANT on DEA Registration: Address: City: _________________________ State: _________ ZipCode: ______________ DEA Registration Number: _________________________ Date of Inventory : _________________ Inventory Taken at: Opening or Closing of business OR Started at (time): _____________ and Ended at (time): _____________ ________________________________________ ______ Signature of Person Responsible For Taking Inventory ________________________________________ ______ Print Name of Person Responsible For Taking Inventory C-II Inventory FOR _________________________ PHARMACY DATE: ____ / ____ / ________ Page 1 PACK DOSE ON HAND UNIT DRUG DESCRIPTION
CONTROLLED SUBSTANCES Inventory Log Name of PHARMACY Name of REGISTRANT on DEA Registration: Address: City: _____ State: _____ ZipCode: _____
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