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If you are interested in becoming Hubang dealer, please fill in the following information*As required, we will contact you as soon as possible!

* Company name:
* Company address:
*Company Responsible:
* E-mail:
Registered capital: 万元(RMB)
Set up time: (格式为:2008-08-08)
At present the company number of employees:
Engaged in the medical industry experience:
Please describe your company's advantage:
*Agent products:

*Agent of province / City:

* If you have a valid business license:"",""" Corporation code certificate, tax registration certificate" ( including the tax certificates and tax certificate ),"" business license to operate medical equipment";
Other notes: