Republic of the Philippines

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

APPLICATION SUMMARY

General Information:

Reference Number: FDA-3000004448179

Authorization: License to Operate
Type of Application: Initial
Product Type: Drug
Primary Activity: Drugstore
Additional Activities: N/A

Establishment Information:

Name of Establishment: MedRx Pharmacy

Owner of Establishment: Gabrielle Anne S. Potenciano
Tax Identification Number: 730577423
Opening Hour: 7:00 AM
Closing Hour: 7:00 PM
E-mail Address: medrx.pharmacyyy@gmail.com
Mobile: 09173850928
Landline:

Site Address:

Address Details: 990 P. Escueta St., Barangay San Antonio,

Biñan
City/Town: Biñan City
Province: Laguna
Region: Calabarzon (Region IV-A)
GPS Latitude: 14.33851
GPS Longitude: 121.08360

Authorized Officer:

Name: Gabrielle Anne Sicat Potenciano

Designation: Owner
Type of Government Identification: Professional Regulation Commission
Identification Number: 0091261
 Expiry Date: 12 August 2025

Qualified Personnel:

Name Designation Gov't ID ID Number Expiry Date Birth Date

Gabrielle Pharmacist Professional 0091261 12 August 12 August

Anne Sicat Regulation 2025 1998
Potenciano Commission

This is not yet an Acknowledgment Receipt of your application. Within 7 working days you will
receive an assessment result which will indicate if your application or requirement is incomplete or
incorrect.

Applications received after 7:00 PM or during weekends/holiday will be considered filed on the
next working day.

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