Lot 36, Jalan Universiti, 46200 Petaling Jaya, Selangor.
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Phone: 603-7841 3200
Fax: 603-7968 2222
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Application for Cancellation of Licence / Permit
The downloadable form attached is applicable to licence/permit holders under the Poisons Act 1952 who wish to cancel their licence/permit.
This application form needs to be submitted to the relevant State Pharmacy Enforcement Branch office together with the original licence/permit to be cancelled.