(c)__Provided the eligible patient with the opinions and advice identified in subsection 5, paragraph A, subparagraph (2), divisions (b) and (c).

(2)__The name, address and date of birth of the eligible patient;

(3)__The name, address and telephone number of the physician providing the written documentation; and

(4)__The name and address of the eligible patient's designated caregiver, as defined in subsection 3, paragraph A-1, if the eligible patient has designated such a caregiver at the time of application.

B.__An eligible patient applying for a registry identification card pursuant to this subsection shall submit the information required in this subsection to the division.__ An eligible patient need not appear in person before the division to apply for a registry identification card.

C.__The division may verify the information contained in an application submitted pursuant to this subsection by contacting the eligible patient's physician.__The division shall approve or deny application for a registry identification card within 30 days of receipt of the application.

D.__The division may deny an application only for the following reasons:

(1)__The eligible patient did not provide the information required by subsection 5, paragraph A; or,

(2)__The division determines that the information provided by the eligible patient was falsified.

E.__Denial of a registry identification card is considered final agency action and is subject to judicial review pursuant to Title 5, chapter 375, subchapter VII.__Only the person whose application has been denied or, in the case of a person under 18 years of age whose application has been denied, the person's parent or legal guardian has standing to contest the division's action.