Fillable Online pharmacy ca Nonresident Sterile 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Pharmacy Name, Address, and Phone number in the designated fields. Ensure that all information is accurate and up-to-date.
3. Select your Ownership type by checking the appropriate box (Sole Owner, Partnership, Corporation, etc.) and fill in your License Number and Expiration Date.
4. Complete the Licensed Sterile Compounding License section by providing the license number and expiration date.
5. List all pharmacy staff members including pharmacists, interns, and technicians. For each individual, enter their RPH or INT number along with their expiration dates.
6. Proceed to answer the self-assessment questions by marking 'Yes', 'No', or 'N/A' for each item. If you select 'No', provide a corrective action plan in the space provided.
7. Once completed, review all entries for accuracy before saving or printing the form. Ensure that signatures are handwritten where required.

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