Pharmacist Interns

Change of Name/Address

A pharmacist intern shall notify the board within 10 days of a change of name by submitting the following

  • A statement requesting a name change and the original intern certificate;
  • A copy of the legal document (e.g., marriage certificate, divorce decree, etc.) that changed the name of the pharmacist intern;
  • Change of Address Form

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For further information, contact the Pharmacist Licensing Intern Specialist