Louisiana Board of Pharmacy

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Forms & Applications

 Pharmacy Technicians & Pharmacy Technician Candidates

 

Pharmacy Technician Candidates

030 ~ Application for New Pharmacy Technician Candidate Registration

031 ~ Pharmacist's Affidavit to Certify Hours of Practical Experience for Pharmacy Technician Candidates

040 ~ Application for New Pharmacy Technician Certificate

090 ~ Notice of Change in Mailing Address or Employment

091 ~ Notice of Name Change

201 ~ Product Order Form - Duplicate Credential

 

Pharmacy Technicians

041 ~ Application for Renewal of Pharmacy Technician Certificate for Year 2015-2016

041-M ~ Application for Renewal of Pharmacy Technician in Active Duty Military Service for Year 2015-2016

041-L ~ Application for Late Renewal of Pharmacy Technician Certificate for Year 2015-2016

090 ~ Notice of Change in Mailing Address or Employment

091 ~ Notice of Name Change

201 ~ Product Order Form - Duplicate Credential



Note:
  If your certificate has been expired for more than 30 days, it is too late to renew it.  However, you can apply for the reinstatement of your certificate.  To do so, please send a written request to the Board office (mail, fax, or email), requesting the information necessary to reinstate your certificate.  Please be sure to include your name, certificate number, and current mailing address.  The licensing staff will prepare a reinstatement packet for you, containing instructions on the procedures necessary to reinstate your certificate.