Arizona State Board of Pharmacy

Protects the health, safety and welfare of the citizens of Arizona

Business Hours feature image

Business Hours

Our office is open Mon-Fri 8:00am-5:00pm except state recognized holidays.

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Follow us on Facebook

The Arizona State Board of Pharmacy is now on Facebook.

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Our Mission feature image

Our Mission

The Arizona State Board of Pharmacy protects the health, safety and welfare of the citizens of...

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Forms

Applications
	Document	Document Type	Last Revision
Licenses	Intern Application Pharmacist Application - Full Exam / Score Transfer Pharmacist Application - Reciprocity Technician Application - PTCB or ExCPT Technician Application - Trainee Technician Application - Reapply Technician Application - Reinstatement	PDF PDF PDF PDF PDF PDF PDF	02.2017 02.2017 02.2017 06.20.2017 06.20.2017 06.20.2017 06.29.2017
Permits	Compressed Medical Gas Distributor Application Compressed Medical Gas Supplier Application Durable Medical Equipment (DME) Application Manufacturer Permit Application Nonprescription Drug Retailer Permit Application Permit Location/Remodel Application Pharmacy Permit Application Pharmacy Permit Application - Hospital Wholesaler Permit Application	PDF PDF PDF PDF PDF PDF PDF PDF PDF	06.26.2017 06.26.2017 06.26.2017 06.19.2017 06.22.2017 10.22.2015 06.16.2017 06.16.2017 06.16.2017
Other	Certificate of Free Sale / Good Manufacturing Practice Immunization Application Intern Preceptor Application Renewal - License Application (for individuals) Renewal - Permit Application (for facilities)	PDF PDF PDF PDF PDF	02.01.2017 08.01.2011 10.22.2015 10.22.2015 10.22.2015

Miscellaneous Forms
	Document	Document Type	Last Revision
	Address / Employment change Duplicate / Replacement Request Character Voucher Consumer Complaint DEA form 41 (Registrants Inventory of Drugs Surrendered) DEA form 106 (Theft or Loss of Controlled Substances) DEA form 224 (Registration Application) Documentation of Eligibility form for Licensure or Renewal Intern Hours Report Management Agreement for Pharmacy change of ownership Requests for Mailing Lists Termination of Employment W-9	PDF PDF PDF PDF PDF Web Web PDF PDF PDF PDF PDF PDF	02.01.2017 05.08.2017 02.2012 10.22.2015 08.31.2014 - - 10.22.2015 10.22.2015 10.22.2015 10.22.2015 10.22.2015 01.30.2017

Quick Links
2017 Graduate Information Apply for license/permit online Verify a license/permit Change your Address / Employment / PIC Submit a Complaint Submit a Fraud Alert Subscribe to e-Bulletin Watch the latest Board Meeting video

JULY INITIAL LICENSING FEES
Licenses
Pharmacist - Invoiced Pharmacist - Reciprocity Pharmacist - Full Exam / Score Transfer Intern Technician - PTCB or ExCPT Technician - Trainee Technician - Trainee Reapply	$50.00 $300.00 $50.00 $60.00 $22.00 $46.00 $36.00
Permits
Pharmacy Nonprescription Retailer - Category I Nonprescription Retailer - Category II Medical Gas - Supplier & DME Medical Gas - Distributor Manufacturer Wholesaler - Nonprescription Wholesaler - Full Service	$80.00 $20.00 $33.33 $16.67 $33.33 $166.67 $83.33 $166.67