ULTRA HIS MINT- green tea leaf, acetylcarnitine hydrochloride, arginine hydrochloride, n-monoacetylcystine, tribulus terrestris fruit, maritime pine, ubidecarenone , lycopene capsule 
CROWN GENERAL AGENCY INC

----------

STATEMENT OF IDENTITY

Dietary Supplement

Suggested Use

Take two (2) capsules daily, after meal(s), or as directed by your healthcare provider. Do not exceed two (2) capsules daily.

Precaution

If reaction(s) occur, consult your physician. Consult your doctor before starting any dietary supplement regime. This product is a dietary supplement, not a prescription drug. Keep out of the reach of children. In case of accidental overdose, call a hospital or poison control center immediately. Do not use if safety seal is damaged or missing. Do not expose to excessive heat or moisture. Store at room temperature in a cool dry place. Keep out of sunlight.

image description

image description

ULTRA HIS MINT 
green tea leaf, acetylcarnitine hydrochloride, arginine hydrochloride, n-monoacetylcystine, tribulus terrestris fruit, maritime pine, ubidecarenone , lycopene capsule
Product Information
Product TypeDIETARY SUPPLEMENTItem Code (Source)NHRIC:73489-005
Route of AdministrationORAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
GREEN TEA LEAF (UNII: W2ZU1RY8B0) (GREEN TEA LEAF - UNII:W2ZU1RY8B0) GREEN TEA LEAF50 mg
ACETYLCARNITINE HYDROCHLORIDE (UNII: NDW10MX58T) (ACETYLCARNITINE - UNII:6DH1W9VH8Q) ACETYLCARNITINE HYDROCHLORIDE400 mg
ARGININE HYDROCHLORIDE (UNII: F7LTH1E20Y) (ARGININE - UNII:94ZLA3W45F) ARGININE HYDROCHLORIDE400 mg
N-MONOACETYLCYSTINE (UNII: YXO5V2CF3F) (N-MONOACETYLCYSTINE - UNII:YXO5V2CF3F) N-MONOACETYLCYSTINE100 mg
TRIBULUS TERRESTRIS FRUIT (UNII: QNL076V6EQ) (TRIBULUS TERRESTRIS FRUIT - UNII:QNL076V6EQ) TRIBULUS TERRESTRIS FRUIT100 mg
MARITIME PINE (UNII: 50JZ5Z98QY) (TRIBULUS TERRESTRIS FRUIT - UNII:QNL076V6EQ) MARITIME PINE100 mg
UBIDECARENONE (UNII: EJ27X76M46) (UBIDECARENONE - UNII:EJ27X76M46) UBIDECARENONE200 mg
LYCOPENE (UNII: SB0N2N0WV6) (LYCOPENE - UNII:SB0N2N0WV6) LYCOPENE10 mg
Inactive Ingredients
Ingredient NameStrength
POWDERED CELLULOSE (UNII: SMD1X3XO9M)  
MAGNESIUM STEARATE (UNII: 70097M6I30)  
SILICON DIOXIDE (UNII: ETJ7Z6XBU4)  
TITANIUM DIOXIDE (UNII: 15FIX9V2JP)  
FD&C BLUE NO. 1 (UNII: H3R47K3TBD)  
FD&C RED NO. 40 (UNII: WZB9127XOA)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NHRIC:73489-005-0130 in 1 BOTTLE, PLASTIC
2NHRIC:73489-005-0260 in 1 BOTTLE, PLASTIC
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
dietary supplement11/29/2019
Supplement Facts
Serving Size : Serving per Container :
Amount Per Serving% Daily Value
flavor
color
shape
size (solid drugs)19 mm
scoring1
Labeler - CROWN GENERAL AGENCY INC (067373836)
Registrant - CROWN GENERAL AGENCY INC (067373836)

Revised: 10/2021
Document Id: 570a36d6-0554-48da-afcb-4961778ad42b
Set id: 0fc229f3-d734-446a-a088-231585fb6807
Version: 2
Effective Time: 20211022
 
CROWN GENERAL AGENCY INC