Date
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Contact*
Email*
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Your P.O. or
Reference
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Clearance Category






Turnaround (applies to clearance categories ONLY)


Consumer Drug and NHP turnaround


Route to (please allow 72 hr turnaround)



Type of Advertisement






Medium





Length/No.of Scripts







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+ please include translation
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Titles/I.D. codes
Previous Numbers (if applicable)


635 QUEEN STREET EAST, TORONTO, ONTARIO, CANADA , M4M 1G4 TEL: 416.964.7539 FAX: 416.778.5989 TOLL FREE: 1.800.463.6456 email: clearances@mijo.com