Sec.21a-115-29. Minimum information required for registration as a wholesaler

The following information shall be required for each application for a registration or a renewal of a registration:

(1) The name, full business address, and telephone number of the registrant;

(2) All trade or business names used by the registrant;

(3) Addresses, telephone numbers, and the names of contact persons for all facilities used by the registrant for the storage, handling, and distribution of prescription drugs;

(4) The type of ownership or operation (i.e., partnership, corporation, or sole proprietorship);

(5) The name(s) of the owner and/or operator of the registrant, including:

(A) If a person, the name of the person;

(B) If a partnership, the name of each partner, and the name of the partnership;

(C) If a corporation, the name and title of each corporate officer and director, the corporate name, and the name of the State of incorporation; and

(D) If a sole proprietorship, the full name of the sole proprietor and the name of the business entity;

(6) An indication as to whether the registrant will distribute controlled substances, legend drugs and/or over the counter drugs as well as a statement concerning the types of drugs to be distributed; and

(7) A change in any information in this section shall be submitted to the Commissioner within 30 days of such change.

(Effective August 27, 1992)