| Name Of the Firm : | Shivam Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At : Saban Bazar, Po/Dist:Bhadrak Plot No.1927/2209/3752, Khata No.723/875 |
| RP Name : | Sri Tapaswini Mishra |
| Registration Number : | 21658 (O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Laxmipriya Biswal. |
| R : | BH-19372/R |
| RC : | BH-19373/RC |
| RX : | BH-6748/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 11/24/2003 |
| Date of Expiry : | 11/23/2013 |
| Remarks : | C/R Not Issued |