![]() ![]() ![]() PIC License issued by Applicant’s Home State.Names, titles, and license/registration numbers for all pharmacists, pharmacist interns, technicians, and pharmacy support persons currently employed or practicing at this location.List of Each Criminal Conviction and Court Records of the Conviction(s).List of Final Denial Orders by Licensing Authorities and Documentation of Final Denial Orders.List of Disciplinary Actions by Licensing Authorities and Documentation of Final Disciplinary Orders.FDA 483s, Warnings Letters, and Responses to each.List of all licenses, permits, and registrations in other states.Please be aware of the reporting requirements described in 657 IAC Chapter 37 of the Board’s rules and the Iowa Data Reporting Manual. Nonresident pharmacies are required to report to the PMP all prescriptions for Schedules II, III, IV, and V controlled substances dispensed to patients located in Iowa, including submission of zero reports when no reportable prescriptions are dispensed during a reporting period.If the PIC is applying for a nonresident pharmacy PIC registration, the Board will issue the registration number once the application is processed.The pharmacy’s toll-free telephone number is required to allow patients to speak with a pharmacist who has access to patient records at least six days per week for a total of at least forty hours.An incomplete application for licensure will only be maintained for a maximum period of 6 months.The application for pharmacy license must be submitted to the Board at least 14 days prior to the anticipated inspection. A new pharmacy location in Iowa requires an on-site inspection by an authorized agent of the board.Resident and Nonresident Pharmacy License (New or Changes) ![]()
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