Form NOI 275 All Practi NOI 275 All Practi NOI 275 All Practitioners Waiver

Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction

Attachment C-NOI 275 All Practitioners Waiver _Clean.rtf

Notice to Treat up to 275 Patients

OMB: 0930-0234