Prophet Inventory
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Account Information
Wholesaler Information
Account ID #:
Wholesaler:
Company:
Account#:
Address:
Address:
City:
City/State/Zip:
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Account Licensing Information
Zip:
DEA#:
Contact First Name:
DEA Exp:
November 2008
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44
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45
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46
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47
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48
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49
30
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6
Contact Last Name:
State Lic.#:
Phone:
Fax:
Email:
Change Password
Current Password:
New Password:
Confirm New Password:
Security Question
Security Question:
Answer:
**The Question / Answer above will be used to recover your password in the event that it is forgotten.
This is Only for DEA 222 Requests. Please choose "Create New inventory" from the menu if you are not doing a C2 return
Inventory Info
Return Name:
Return Date:
November 2008
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44
26
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31
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45
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46
9
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47
16
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48
23
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49
30
1
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6
IMPORTANT:
Full: Please enter the number of full containers (i.e. 1 for 1 bottle)
Partial: Please enter exact quantity if partial container (i.e. 35 for 35 tablets)
NDC:
Full:
Description:
Strength:
Lot:
Partial:
Manufacturer:
Exp Date:
November 2008
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M
T
W
T
F
S
44
26
27
28
29
30
31
1
45
2
3
4
5
6
7
8
46
9
10
11
12
13
14
15
47
16
17
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20
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22
48
23
24
25
26
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28
29
49
30
1
2
3
4
5
6
Pkg Size:
Dosage:
Inventory Info
Return Name:
Return Date:
November 2008
S
M
T
W
T
F
S
44
26
27
28
29
30
31
1
45
2
3
4
5
6
7
8
46
9
10
11
12
13
14
15
47
16
17
18
19
20
21
22
48
23
24
25
26
27
28
29
49
30
1
2
3
4
5
6
Sample:
NDC Code:
Full Qty:
Partial Qty:
Description:
Manufacturer
Strength:
Dosage:
Control: