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Order of Payment: Food and Drug Administration

This document is an order of payment from the Philippines Food and Drug Administration for the renewal of the license to operate of Farmacia Madanom. It provides details such as the account code, authorization type, expiry date, establishment information including the owner and address, payment details including application fee and total amount due, and remarks that this is for license renewal and the computation is valid until April 2020. The document also lists the qualifying personnel including the pharmacist at Farmacia Madanom.

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Laarnie Linggayo
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84 views

Order of Payment: Food and Drug Administration

This document is an order of payment from the Philippines Food and Drug Administration for the renewal of the license to operate of Farmacia Madanom. It provides details such as the account code, authorization type, expiry date, establishment information including the owner and address, payment details including application fee and total amount due, and remarks that this is for license renewal and the computation is valid until April 2020. The document also lists the qualifying personnel including the pharmacist at Farmacia Madanom.

Uploaded by

Laarnie Linggayo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Health
Food And Drug Administration
Civic Drive, Filinvest Corporate City 
Alabang, Muntinlupa City

Order of Payment
General Information
Account Code: 3000006136074
Product Center: Drugs
Authorization: License To Operate
Type: Renewal
Primary Activity: Drugstore
LTO No. (If applicable): CDRR CAR D51020
Expiry (If applicable): 2019-12-14
 
Establishment Information
Company Name: Farmacia Madanom
Owner: Mario D. Madanom
Declared Capital: Not Applicable
Poblacion, Paracelis, Mountain Province, Poblacion, Paracelis,
Site Address (if applicable): Mountain Province, Paracelis, Mountain Province, Cordillera
Administrative Region (CAR), 2625
Office Address (if
Not Applicable
applicable):
Plant Address (if applicable): Not Applicable
List of Warehouses (if applicable):
Address
  
Details of the Approving Authority
Fullname: Madanom, Mario Dampag
Designation: Owner (for sole proprietorships)
Paracelis, Mounatian, Paracelis, Mountain Province, Cordillera
Mailing Address:
Administrative Region (CAR), 2625
  
Details of the Qualified Personnel
Fullname Designation TIN Email Government ID
Professional
Regulatory
Madanom, Company
917-007-035-000 [email protected] Commission: 0032514
Flora Olosan Pharmacist
(1970-09-18)
(2022-09-18)
  
Payment Details
Application Fee: 3,000.00
Number of Years Applied: 3
Surcharge (if any): 7,200.00
Legal Research Fund (LRF): 30.00
Total Amount: Php 10,230.00

If payment is made using Bancnet Online Bills Payment Facility (www.bancnetonline.com), an


additional Php15.00 should be included to the amount due.

BancNet Payment: Php 10,245.00  

Remarks: Renewal, Computation is Valid Until 14 April 2020

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