Change of Permit - Board of Pharmacy - State of California 2026

1. Click ‘Get Form’ to open the Change of Permit application in the editor.
2. Begin with Section A, where you will select the applicable changes and corresponding fees. Ensure you mark all that apply and complete the relevant sections.
3. In Section B, provide your Licensee Information. Fill in your name as it appears on your current license, along with your address, email, and telephone number.
4. Proceed to Section C for Contact Person and Authorized Signer details. Enter the contact person's name, telephone number, and email address.
5. If applicable, complete Sections D through I based on the type of change (address, tradestyle name, corporate name, etc.). Attach any required supporting documentation as specified.
6. Finally, review Section J for Required Signatures. Ensure all signatures are original as scanned or electronic signatures may not be accepted.

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