HKorva Pharma

Controlled Substance KYC

Controlled Substance Questionnaire

DEA "Know Your Customer" declaration per 21 CFR 1301.74. Required before Korva Pharma can ship Schedule II–V controlled substances to your facility.

Controlled Substance Questionnaire

Complete all six steps. Required fields are marked with a red asterisk.

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Step 1 of 6: Identification

Person Completing This Form

Business Information