Renewal applications for the 2018-2019 renewal period: [for licenses expiring in the year 2018]

Renewal applications for the 2019-2020 renewal period: [for licenses expiring in the year 2019]

**Applications for NEW license or CHANGE of Name, Ownership or Location:** [also see required ownership forms below]

Manufacturer (including Virtual Manufacturers)
Medical Gas Distributor
Medical Gas Supplier
Outsourcing Facility
Repackager
Third-Party Logistics (3PL) Provider
Wholesale Distributor

Each new application or application for change of Name, Ownership or Location must also have one of the following ownership forms attached. Please choose your type of ownership and attach the appropriate form to your application:

- Form A - Sole Proprietor or Partnership
- Form B-1 - Corporation (not publicly traded)
- Form B-2 - Corporation (publicly traded)
- Form C - Limited Liability Company
- Form D - Government

Licenses are non-transferable! A new application is required for any change of owner, change of location or change of name.

Other forms & guidelines:

Last Modified on 12/06/2018

FAQs

Q: When will I receive a renewal for my license?
A: Renewal applications for pharmacies and facilities are mailed approximately 60 days in advance of the date of expiration. If needed, registrants may download a renewal application form from the Board website.

Interesting Facts

"GAS DISTRIBUTOR" - a business that may sell medical gases on drug orders issued to patients and to medical gas suppliers or other entities licensed to use, administer, or distribute medical gases.

"GAS SUPPLIER" - a business that may sell medical gases only on drug orders issued to a patient.