Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.

Thomas F. Hughes III, MD

6044 Main Street; Suite 106
Williamsville, New York 14221

Phone (716) 626-5840
Fax (716) 626-9178

DEA Number BH 6437051
NYS Lic. # 206866-1

Name:
Address:

John Doe
71 Stonecroft Lane
Amherst, New York 14226

10-3-1979

4-3-2002

DOB:

Date:

Foo man Chu
Sig: Never
Disp: 50

Allergies: NKDA


Thomas F. Hughes III, MD

Refills: 10

Label:    x
NR:    x

Prescription #12345689

THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES 'd a w' IN THE BOX ABOVE.