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WIC Program Store Brand Declaration Form
Form 1112
This page has been automatically translated from English. MSDH has not reviewed this translation and is not responsible for any inaccuracies.
WIC Program Store Brand Declaration Form
Last reviewed on Feb 13, 2024
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Mississippi State Department of Health
•
570 East Woodrow Wilson Dr
•
Jackson, MS 39216
•
866‑HLTHY4U
•
Contact and information