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Prescriber s Information Limit of 16 prescribers per pad. Check boxes are added to prescribers names to clearly identify multiple prescribers Prescriber Name Alternative Line/Speciality Degree s License License Display Option DEA DEA Display Option Do Not Print Blank Line Only There are more than 4 prescribers on this prescription pad. I have attached an additional page listing the other prescribers. Print Form Reset Form SECUREDSCRIPTS.COM 5 x 8 Tamper-Resistant Prescription Order Form Toll...
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