| Name Of the Firm : | Shriram Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At / P.O. : B.T.Pur, Dist : Bhadrak Plot No.: 317/844, Khata No. : 230/14 |
| RP Name : | Sri Arabinda Jena |
| Registration Number : | 17621(O.P.C) |
| Competent Person : | -- |
| Qualification : | D-Pharm |
| Name of the Proprietor : | Sri Nityananda Rout |
| R : | BH-28541/R |
| RC : | BH-28542/RC |
| RX : | BH-11283 /RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 2013.08.12 |
| Date of Expiry : | 2018.08.11 |
| Remarks : | Up to date Licence |