Application for License as a Consultant Pharmacist

This form must be completed for each institution or facility in which consultation or coordination is performed. Fee is $20.00 for each facility payable by credit card only.

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Please login below to access the online renewal form. Remember to prefix your License Number with RP. Do not add a space between the prefix and the number.




Page Updated: 1/3/2018 11:26:08 AM