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Forms and Instructions

Pharmacist Licenses/Permits
Change of Pharmacist in Charge
Change of Pharmacist in Charge Extension Form 
License by Examination 
License by Reciprocity 
Pharmacist License Reinstatement Form
Compounding Questionnaire 
Nursing Home Consultant 
Preceptor Application 
Foreign Applicants 
Administer Immunization Certification 
Interns
Intern Application
Intern Training Plan 
Affidavit of Experience 
Pharmacy Technicians
2017 Pharmacy Technician Application
Pharmacy Technician Reinstatement
Business Licenses
Retail Pharmacy Application - In State 
Retail Pharmacy Application - Out of State 
Hospital Pharmaceutical Services 
Institutional Pharmaceutical Services 
Wholesale Distributor of Legend Drugs 
Supplier of Medical Equipment, Legend Devices, and Medical Gas (DME license) 
Wholesale Distributor of List I Chemicals 
Charitable Clinic Application 
Pharmacist in Charge Compliance Affidavit 
Other Forms
Criminal Background Check Identity Verification Form 
BEGINNING JANUARY 1, 2018 THE ARKANSAS STATE BOARD OF PHARMACY WILL NO LONGER REVIEW AND APPROVE EDUCATION SESSIONS AS CONTINUING EDUCATION HOURS, THAT ARE NOT CO-SPONSORED/DEVELOPED BY THE ARKANSAS STATE BOARD OF PHARMACY.  IF YOU HAVE QUESTIONS OR CONCERNS ABOUT THIS, CALL THE BOARD AT 501-682-0190.
CE Approval Request Form  * See Notice Above*
CE Approval Request Form | Word  * See Notice Above*
Change Form 
Closing of Pharmacy Form 
Complaint Form 
Inspection Request Form 
Order Form 
Request for Waiver Form 
Other Resources
Samples of protocols, authority to administer immunizations, and sample forms for immunizations/vaccines 
Suggested Procedures When Buying or Selling a Pharmacy 
Effects of New Federal Meth Act on Arkansas Pseudo Law 
Multidose Memorandum of Understanding 
Shrink Report Tool | Excel
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Arkansas State Board of Pharmacy
322 South Main Street, Suite 600
Little Rock, AR 72201
Phone: 501.682.0190
Fax: 501.682.0195
asbp@arkansas.gov
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