Mount Carmel Institutional Review Board

Drug/Biologic Name(s) as listed in the protocol along with a description of dose range, frequency and route of administration: IND # N/A. Yes. Provide # Investigator’s IND #; it will expire: * If this is an Investigator’s IND #, the FDA letter must be attached to this form and the 30-day expiration date provided above. ................
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