The Herbal Care Center
Medical Cannabis Dispensary Selection

Complete the following information and email to DPH.ChangeDispensary@Illinois.gov , fax to 217-782-1321, or mail to:

Illinois Department of Public Health
Division of Medical Cannabis
535 W.Jefferson Street; MC-002
Springfield, IL 62761-0001

Select One:

This is the first time I am selecting a medical cannabis dispensary

I am requesting a change in my medical cannabis dispensary


Name
Date of Birth
Patient Registry Identification Number QP:
EMAIL
Phone Number
Address
City
Name and Address of Dispensary The Herbal Care Center
1301 South Western Avenue
Chicago, IL 60608
Dispensary District 48

The Medical Cannabis Program will confirm your dispensary selection once it is processed. You do not need to select a medical cannabis dispensary at this time. However, you must select a dispensary in order to purchase medical cannabis. The list of dispensaries currently licensed with the state of Illinois can be viewed at http://www.idfpr.com/Forms/MC/ListofLicensedDispensaries.pdf

The Herbal Care Center