| Name Of the Firm : | Shiva Medicine Store |
| Zone : | Central Zone |
| Range : | Bhadrak |
| Police Station : | |
| Address : | At /P.O : Puruna Bazar, Dist : Bhadrak Plot No. 969, Khata No. 348 |
| RP Name : | Sri Mukesh Ku. Behera |
| Registration Number : | 24034(O.P.C) |
| Competent Person : | -- |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Trupti Pattanaik. |
| R : | BH-25737/R |
| RC : | BH-25738/RC |
| RX : | BH-9926/RX |
| RR : | -- |
| RRC : | -- |
| W : | -- |
| WC : | -- |
| WX : | -- |
| Date of Issue : | 10/4/2010 |
| Date of Expiry : | 10/3/2015 |
| Remarks : | Up to date licence |