Life Bee

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- Name of the Store
- Name of the Owner/Owners/Parent Company or Enterprise*
- Location
- Complete Address*
- Email Address*
- Phone*
- Website
- Retail Or Wholesale* Retail Wholesale
- Retail Drug Licence (RDL)
  
  Wholesale Drug Licence (WDL)
- Name of the Person Holding Valid Pharmacy Council License *
- Details of Licence
- TIN details
- List Of Available Products *
  Must provide available products in xls/xlsx/csv format.
- User Name
- Password
- Confirm Password
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