Republic of the Philippines ​Departmentof Health Food

​ And Drug Administration ​Civic

Drive, Filinvest Corporate City
Alabang, Muntinlupa City
Order of Payment ​General Information ​Account Code: 3000004879021 Product
Center: Drugs Authorization: License To Operate Type: Initial Primary Activity:
Drugstore LTO No. (If applicable): Not Applicable Expiry (If applicable): Not Applicable
Establishment Information ​Company Name: M2N Pharmacy Owner: Ma. Loraine A.
Tikiw, San Antonio,
Nuñez Declared Capital: Not Applicable Site Address (if applicable): ​
Nueva Ecija, Central Luzon

(Region III), 3108 Office Address (if applicable): Not Applicable Plant Address (if
applicable): Not Applicable List of Warehouses (if applicable): ​Address
Details of the Approving Authority ​Fullname: Nuñez, Ma. Loraine Aguilar
Langla , Jaen, Nueva
Designation: Owner (for sole proprietorships) Mailing Address: ​
Ecija, Central Luzon (Region III),

3109
Details of the Qualified Personnel Fullname Designation TIN Email Government ID
Sulit, Marry Joyce Mascareñas
321-086-899 sulitmjoyce@gmail.com
Professional Company Pharmacist ​
Regulatory Commission: (1993-08-25)
0066086
(2021-08-25)
Payment Details ​Application Fee: 2,000.00 Number of Years Applied: 2 Surcharge (if
any): 0.00 Legal Research Fund (LRF): 20.00 ​Total Amount: Php 2,020.00
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 2,035.00

Remarks: Initial