| Name Of the Firm : | Suprava Med. Store |
| Zone : | Central |
| Range : | BBSR-II |
| Police Station : | |
| Address : | Plot No-388/2244, Patrapada |
| RP Name : | Piyush Ku Routray |
| Registration Number : | 12935/opc |
| Competent Person : | - |
| Qualification : | D.Pharm |
| Name of the Proprietor : | Pratap Ku Pattnaik |
| R : | 24724 |
| RC : | 24725 |
| RX : | 9421 |
| RR : | - |
| RRC : | - |
| W : | - |
| WC : | - |
| WX : | - |
| Date of Issue : | 8/3/2009 |
| Date of Expiry : | 8/2/2014 |
| Remarks : |