RENEWAL FORMS

*IMPORTANT*  You Will Need The Latest Version of Adobe Acrobat / Reader To Access Forms.  Click on any [PDF] link to download it.  Before printing the PDF documents, make sure you have checked 'print as image' in your Print Dialog Box, then print.

Credit Card Transmittal Form  [PDF]

Individual Renewals - All indviduals that are registered/licensed with the Board and have received their renewal postcard are able to renew online. Postcards with the information needed to utilize the online renewal system will be mailed on May 5, 2010. Pharmacist, Technician and Veterinary Drug Technicians - Renew online here or you may download the appropriate form and mail with payment.

Certified Pharmacy Technician Renewal

Pharmacy Technician Renewal (Grandfathered)

Pharmacist Renewal

Veterinary Drug Technician Renewal

Facility Renewals Facilities located within Idaho that have received their renewal postcard may renew online here or download the appropriate form to renew by mail. Postcards with the information needed to utilize the online renewal system will be mailed on May 5, 2010 to the mailing address on file with the Board office.

Pharmacy Renewal - Use this form for facilities located in IDAHO ONLY Community, Hospital, Limited Service, Parenteral Admixture and Remote Dispensing Pharmacy

Durable Medical Equipment Renewal-This form and online renewal is for facilities located in Idaho ONLY

Institutional Drug Outlet (Nursing Home)

Mail Service Pharmacy Renewal (located outside of Idaho)

Manufacturer of Legend Drugs and/or Controlled Substances Renewal

Manufacturer of OTC and/or Legend Drugs Renewal

Non-Pharmacy Drug Outlet Renewal

OTC Wholesaler Renewal

Preceptor Site Renewal

Veterinary Drug Outlet Renewal

Wholesaler & Wholesaler w/Distributor of Controlled Substances Renewal

Please use these email links to contact Ellen Mitchell or Sharon Treese with any questions.

CONTROLLED SUBSTANCE REGISTRATION RENEWALS 2009

Practitioner Reinstatement (paper form)

Controlled Substance registrations that expired December 31, 2009 must now be reinstated. You may apply for reinstatement using this form. For further information you may email Ellen Mitchell at the Board office.

Last update - 05/06/2010