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Form from www.needymeds.org ACTIVIST PHARMA, INC. PATIENT ASSISTANCE PROGRAM PO BOX 66764 St. Louis, MO 63166 Phone (800) 8510758/Fax (844) 7080036/ allergan.com/pap PATIENT ASSISTANCE PROGRAM The
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Actavis Pharma Inc is a pharmaceutical company that produces and markets generic drugs.
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