Complete the form below or download the Medical Cannabis Dispensary Selection Form and email, mail or fax the completed form to: 

Email: dph.changedispensary@illinois.gov

-or-

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

-or-

Fax: 217-782-1321

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Dispensary Information