Standard Prescription Pad, White 5.5"x4.25, (Not Security, single form)

Customize this item in 3 simple steps:
1. Enter the appropriate data
2. Check your customized PDF proof
3. Order the item

It's that easy!
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Each 5.5"x4.25" pad has 50 prescriptions
Minumum order is 5 pads
Price: $6.00 each
Step 1: Enter Your Custom Information
Please enter the information that you would like to appear on your prescription pad.
Please carefully check the accuracy of all the information on your PDF proof.
Doctor Firstname Lastname
License Category (MD,DDS,etc.)
Practice (optional)
CA License number
DEA number
NPI number (optional)
Medical Group Name
Address line 1
Address line 2
Phone
Fax
Step 2: Check Your PDF Proof
(No PDF Proof available, please complete Step 1)
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