Clinical Registrant Phase II Applicant Information

Clinical Registrant Phase II Applicant Information

Clinical Registrant Information

ID Number Name

CR01

Laurel Harvest Labs LLC

Purported ACRC Name Primary Contact Name

Temple University

Andrew N. Dodge

Primary Contact Phone 717-917-8556

Primary Contact Email Andrew@

Source: Clinical Registrant application section 1 & 2

Dispensary Business Information

ID Number

Name

Region Org Type

Address

City

State Zip Code Phone

Fax

Email

CR01-D19-1201 Laurel Harvest Labs LLC

Southeast Limited Liability 119 South Tree Drive Lancaster PA Company

17603

717-917-8556

andrew@

Source: Dispensary application section 1 & 18

Dispensary Facility Information*

Primary Name

Primary County

Lackawanna

Second Name

Second County Montgomery

Source: Dispensary application section 2

Dispensary Current Officer(s)

First Name Andrew

Middle Name Nikolaus

Nicholas

Mitchell

Bryan

Glenn

Curtis

Scott

Eric

Michelle

Athanas

Therese

Marie

Sunshine

Liberty

Source: Dispensary application section 20

Last Name Dodge Karalis Baruchowitz Taylor Rosenthal Karalis Mellet Brosi

Suffix

R.Ph. Esq.

D.O., P.C. R.Ph.

PhD

Occupation Managing Director, Ecore International Chief Executive Officer, Elwyn Pharmacy Group Managing Partner, Merida Capital Partners Member, Board of Governors Physician, Pinnacle Pain Management Founding Member, Tetra Rx Chief Administrative Officer, Merida Capital Partners Professor, Biology Department, Frostburg State University

Title in Applicant's business President/Chief Operating Officer Chief Executive Officer Chief Marketing Officer Chief Financial Officer Chief Medical Officer Chief Pharmaceutical Officer/Chief Diversity Officer Chief Administrative Officer Chief Scientific Officer

* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.

PA DOH

Page 1 of 23

June 19, 2019

Clinical Registrant Phase II Applicant Information

Grower/Processor Business Information

ID Number

Name

CR01-GP19-1201 Laurel Harvest Labs, LLC

Source: Grower/Processor application section 1 & 23

Region Southeast

Org Type

Limited Liability Company

Address

City

State

119 South Tree Drive Lancaster PA

Zip Code Phone

Fax

17603 717-917-8556

Grower/Processor Facility Information

Name

Address

279 South Barbara Street

City Mount Joy

Zip Code 17552

County Lancaster

Municipality Mount Joy Borough

Email andrew@

Source: Grower/Processor application section 2

Grower/Processor Current Officer(s)

First Name Andrew

Middle Name Last Name

Nikolaus

Dodge

Nicholas

Karalis

Mitchell

Bryan

Baruchowitz

Glenn

Curtis

Taylor

Scott

Eric

Rosenthal

Michelle

Athanas

Karalis

Therese

Marie

Mellet

Sunshine

Liberty

Brosi

Source: Grower/Processor application section 25

Suffix

R.Ph. Esq.

D.O., P.C. R.Ph.

PhD

Occupation Managing Director, Ecore International Chief Executive Officer, Elwyn Pharmacy Group Managing Partner, Merida Capital Partners Member, Board of Governors, Leafline Labs LLC Physician, Pinnacle Pain Management Founding Member, Tetra Rx Chief Administrative Officer, Merida Capital Partners Professor, Biology Department, Frostburg State University

Title in Applicant's business President/Chief Operating Officer Chief Executive Officer Chief Marketing Officer Chief Financial Officer Chief Medical Officer Chief Pharmaceutical Officer/Chief Diversity Officer Chief Administrative Officer Chief Scientific Officer

PA DOH

Page 2 of 23

June 19, 2019

Clinical Registrant Phase II Applicant Information

Clinical Registrant Information

ID Number Name

Purported ACRC Name

CR02

CannTech PA, LLC

Lake Erie College of

Osteopathic Medicine

(LECOM)

Source: Clinical Registrant application section 1 & 2

Primary Contact Name Primary Contact Phone Danielle Alvarez Wolf, Esq. 908-764-8286

Primary Contact Email danielle@law.mw

Dispensary Business Information

ID Number

Name

CR02-D19-6701 CannTech PA, LLC

Source: Dispensary application section 1 & 18

Region Org Type

Northwest Limited Liability Company

Address

City

c/o Eckert Seamans Cherin & Mellott, Harrisburg LLC, 213 Market Street, 8th Floor

State PA

Zip Code Phone

Fax

17101 908-764-8286 201-533-0701

Email danielle@law.mw

Dispensary Facility Information*

Primary Name Primary County

CannTech

Erie

Fairview

Dispensary

Source: Dispensary application section 2

Second Name

CannTech Norristown Dispensary

Second County Montgomery

Third Name

CannTech Bensalem Dispensary

Third County Bucks

Fourth Name

CannTech Gibsonia Dispensary

Fourth County Allegheny

Fifth Name

CannTech Harrisburg Dispensary

Fifth County Dauphin

Dispensary Current Officer(s)

First Name John

Middle Name Tarik

Hannah

H

Madhevan

Palpu

Alex

R.

Sean

Paul

Austin

Kemel Aaron Min Edward

W. Jason

Marvin

Last Name Bey Iglesias Asokan Collins Band Higdon

Dawkins Epstein Chu Miller

Suffix

II Esq. Ph.D. MD

Occupation

Title in Applicant's business

PAANG, Superintendent, Comptroller Office President, Treasurer, PA Chief Security Officer

Paralegal

Compliance Officer

Cannabis Horticulturist

Chief Horticulturist

Director of Products Manufacturing

Director of Product Development

Cannabis Horticulturist

Director of Cannabis Horticulture

Law enforcement (retired DEA and INTERPOL) Financial Consultant

National Chief Security Officer CEO

Attorney, Dispensary Manager

Chief Operating Officer

Chemist

Chief Scientific Officer

Physician; hospital administrator

Chief Medical Officer

PA DOH

Page 3 of 23

June 19, 2019

First Name Susan

Middle Name

Danielle

Y.

Source: Dispensary application section 20

Clinical Registrant Phase II Applicant Information

Last Name Taylor

Alvarez-Wolf

Suffix MD

Esq.

Occupation Physician

Attorney

Title in Applicant's business Chair of Medical Advisory Board; Chairman of the Board of Managers Chief Legal Officer; Secretary

* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.

PA DOH

Page 4 of 23

June 19, 2019

Clinical Registrant Phase II Applicant Information

Grower/Processor Business Information

ID Number

Name

Region

CR02-GP19-5701 CannTech PA, LLC Southwest

Org Type

Limited Liability Company

Source: Grower/Processor application section 1 & 23

Address

c/o Eckert Seamans Cherin & Mellott, LLC, 213 Market Street, 8th Floor

City

State

Harrisburg PA

Zip Code Phone

Fax

Email

17101 908-764-8286 201-533-0701 danielle@law.mw

Grower/Processor Facility Information

Name

Address

CannTech PA, LLC Medical

535 Keystone Drive

Marijuana Grower/Processor Facility

Source: Grower/Processor application section 2

City

Zip Code

Warrendale 15086

County Allegheny

Municipality Marshall Township

Grower/Processor Current Officer(s)

First Name John

Middle Name Last Name

Tarik

Bey

Hannah

H

Iglesias

Madhevan

Palpu

Asokan

Alex

R.

Collins

Sean

Band

Paul

Austin

Higdon

Kemel

W.

Dawkins

Aaron

Jason

Epstein

Min

Chu

Edward

Marvin

Miller

Susan

Taylor

Danielle

Y.

Alvarez-Wolf

Source: Grower/Processor application section 25

Suffix

II Esq. Ph.D. MD MD Esq.

Occupation

Title in Applicant's business

PAANG, Superintendent, Comptroller Office President, Treasurer, PA Chief Security Officer

Paralegal

Compliance Officer

Cannabis Horticulturist

Chief Horticulturist

Director of Products Manufacturing

Director of Product Development

Cannabis Horticulturist

Director of Cannabis Horticulture

Law enforcement (retired DEA and INTERPOL) National Chief Security Officer

Financial Consultant

CEO

Attorney, Dispensary Manager

Chief Operating Officer

Chemist

Chief Scientific Officer

Physician; hospital administrator

Chief Medical Officer

Physician

Chair of Medical Advisory Board; Chairman of the Board of Managers

Attorney

Chief Legal Officer; Secretary

PA DOH

Page 5 of 23

June 19, 2019

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