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| Section 10,
Article 5, Chapter 30 of the Code of West Virginia requires that
every registered pharmacy technician within this state shall on or
before July 1 apply to the State Board of Pharmacy for annual
renewal of his or her certificate. Complete the following form, fill
in all categories as required, return with the fee of $30 payable to
the West Virginia Board of Pharmacy. |
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| Note: Since last
renewal, have you been convicted of any felony or infraction of
pharmacy laws? _____ Yes _____ No | |