Form 2687-2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Type of License Applying For' section. Select the appropriate license type from the options provided.
  3. Enter your personal information, including your last name, first name, and middle initial. If applicable, include any former or maiden names.
  4. Complete the race and sex information as required for the criminal background check. This includes selecting your race and gender from the provided options.
  5. Provide your Wisconsin License Number if you have one, followed by your current address including street, city, state, and zip code.
  6. Sign and date the form at the bottom to validate your application.
  7. If applying as a Wholesale Distributor of Prescription Drugs, ensure to fill in the DBA Name and Facility’s Address along with Designated Representative’s details.

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Versions Form popularity Fillable & printable
2021 4.8 Satisfied (67 Votes)
2018 4.4 Satisfied (203 Votes)
2018 4.2 Satisfied (26 Votes)
2014 3.9 Satisfied (44 Votes)
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