Get Michigan State University Annual Controlled Substance Inventory Form

Michigan State University Annual Controlled Substance Inventory Form Inventory must be performed between April 1 and June 30 of each year. A separate annual inventory is required for each registered location. Mail to State of Michigan Bureau of Health Professions Health and Regulatory Division Annual Inventory 6546 Mercantile Way Suite 2 P. O. Box 30454 Lansing MI 48909. Retain a signed and completed copy of this form at the licensed location. The completed form can serve as the biennial inventory required by the DEA. Date MI Licensee/DEA Registrant Name DEA Registration State of MI Controlled Substance ID Start of day End of day DEA Schedule Controlled Substance Container Unit Type Vial syringe patch etc. Container Quantity Container Volume Concentration Schedule I and II controlled substances must be separated from all other substances or places on a separate form. Inventory performed by Print Name Signature Inventory witnessed by Page of. A separate annual inventory is required for each registered location* Mail to State of Michigan Bureau of Health Professions Health and Regulatory Division Annual Inventory 6546 Mercantile Way Suite 2 P. O. Box 30454 Lansing MI 48909. Retain a signed and completed copy of this form at the licensed location* The completed form can serve as the biennial inventory required by the DEA. Date MI Licensee/DEA Registrant Name DEA Registration State of MI Controlled Substance ID Start of day End of day DEA Schedule Controlled Substance Container Unit Type Vial syringe patch etc* Container Quantity Container Volume Concentration Schedule I and II controlled substances must be separated from all other substances or places on a separate form* Inventory performed by Print Name Signature Inventory witnessed by Page of. A separate annual inventory is required for each registered location* Mail to State of Michigan Bureau of Health Professions Health and Regulatory Division Annual Inventory 6546 Mercantile Way Suite 2 P. O. Box 30454 Lansing MI 48909. Retain a signed and completed copy of this form at the licensed location* The completed form can serve as the biennial inventory required by the DEA. O. Box 30454 Lansing MI 48909. Retain a signed and completed copy of this form at the licensed location* The completed form can serve as the biennial inventory required by the DEA. Date MI Licensee/DEA Registrant Name DEA Registration State of MI Controlled Substance ID Start of day End of day DEA Schedule Controlled Substance Container Unit Type Vial syringe patch etc* Container Quantity Container Volume Concentration Schedule I and II controlled substances must be separated from all other substances or places on a separate form* Inventory performed by Print Name Signature Inventory witnessed by Page of. .