| Name Of the Firm : | Prakash Medical Store |
| Zone : | Southern Zone |
| Range : | Ganjam I |
| Police Station : | |
| Address : | Plot no-1051/3095,Khata no-742/1200,Holding no-18062,Word no-23,At: Main Road, Gosaninuagam, BAM, Ganjam |
| RP Name : | Sri Simadri Prasad Nayak |
| Registration Number : | 2485 (OPC) |
| Competent Person : | |
| Qualification : | D. Pharm |
| Name of the Proprietor : | Sri Amiya Kumar Dalai |
| R : | GAI-6815 |
| RC : | GAI-6816 |
| RX : | GAI-6817 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 2012.11.22 |
| Date of Expiry : | 2017.11.27 |
| Remarks : |