Pennsylvania pharmacy board: Fill out & sign online

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Click ‘Get Form’ to open the PHARMACY REMODELING APPLICATION in the editor.
Begin by selecting the transaction type at the top of the form. Check the appropriate box for either a new registration or any changes, and ensure you note the corresponding fee.
Fill in your pharmacy's name, permit/license number, and address as registered in your resident state. This information is crucial for proper identification.
If applicable, provide details regarding any changes in location, ownership, or pharmacist in charge. Include former details and effective dates as required.
Complete the ownership information section by checking the type of ownership and providing necessary details about all principal officers.
Finally, review all sections for accuracy before signing the verification statement at the end of the application. Ensure that all required documents are attached.

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