Notice of Change

Changes in any information required for licensure must be reported to the Board within ten (10) days [535:25-3-7(d)]. This includes name, address, employment, etc.

1. Pharmacists, Interns and Technicians may use the form below to report a change of address and/or change of employment via mail.
   • Changes are also accepted via e-mail and fax. [see Board contactinfo]
   • To submit a change on-line click here.
2. Licensed pharmacies and facilities must complete a new application for any change of owner, change of location or change of name (see "Download Forms").

• Notice of Address or Employment Change

All files are formatted in Adobe Acrobat.  If you do not have an Acrobat Reader, you may download a free Acrobat Reader by clicking on the box below.