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FDA Facility Establishment Identifier c. FDA Data Universal Numbering System d. FDA Expiration Date e. If this Facility is LOCATED IN OKLAHOMA complete the following 1. This facility is located in County of Oklahoma. E. Facility Registration / License Information FDA Registration Required if Transfilling attach copy a. FDA Firm Name b. Signature of Facility Manager/Representative Notary Public THE FOLLOWING MUST BE SUBMITTED WITH THIS APPLICATION 400 Application Fee Copy of Home State...

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