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Renewal applications are mailed at least sixty (60) days prior to the expiration date. This application is mailed to your address of record with the Board. The Board has no way of knowing whether or not the application reaches its destination; therefore, when it has been mailed, the duty of the Board has been performed. Please allow 10-14 business days to receive your application. If you do not receive your renewal application, please email our office at pla4@pla.IN.gov and we can e-mail you a renewal application to be printed and completed.
In order for your pharmacist intern registration to be renewed, you must submit the following to the address listed on the renewal application:
à If we do not receive the required or correct documentation, your renewal application may be denied. PLEASE SEE BELOW FOR SPECIFIC DOCUMENTATION REQUIREMENTS!
DOCUMENTATION REQUIREMENTS FOR ALL INTERN RENEWALS
Current Pharmacy Students Enrolled in an ACPE Accredited Pharmacy Program: You are required to submit official transcripts from your ACPE accredited school of pharmacy with your registration renewal application. The official transcripts must verify your active/current enrollment in the spring 2011 semester or corresponding quarter by indicating "currently enrolled", "work in progress", etc., for your currently enrolled semester or quarter. An official transcript indicating only the previous semester or quarter completed will not be accepted as it does not verify that current enrollment.
ACPE Accredited Pharmacy Program Graduates: You are required to submit official transcripts indicating the date your pharmacy degree was conferred or a notarized copy of your college diploma.
Foreign Pharmacy Graduates: You are required to submit a notarized copy of your Foreign Pharmacy Graduate Examination Committee (FPGEC) Certificate.
DOCUMENTATION REQUIREMENTS FOR “YES” RESPONSES
If you answered “yes” to any of the questions on the renewal application, then you must explain fully, including all related details, in a signed and notarized statement. You must also submit documentation regarding to the incident(s) in question. Below, find a list of documentation that will be requested by the Board if not submitted. The Board may, however, request information in addition to what is listed below upon reviewing the information you submit.
Documentation Required for “Yes” Responses on the Registration Renewal Application
Question #1: Copies of all orders filed against the professional license. If action has been lifted against your license, then verification of this is required as well.
Question #2: Submit a copy of the denial notification as well as any other documentation relating to the denial.
Question #3: Submit all related court documentation that indicate the charge, plea, sentence requirements, and, if the sentencing requirements have been met, verification of successful completion of sentencing requirements.
Question #4: Submit a current evaluation from an approved addictionologist and any other related documentation related to your diagnosis and/or treatment.
Question #5: Nothing additional; however, after reviewing your statement, the Board may request additional information.
Blue Wall Licenses and Pocket cards (“Blue Cards”)
à The Professional Licensing Agency no longer sends blue wall certificates and pocket cards upon successful renewal of your registration. To satisfy posting requirements, you are required to either purchase the certificate/pocket card combo available online or print off the free paper version following successful completion of your renewal. You will need to verify renewal at http://www.in.gov/pla/license.htm; once renewal is verified, you may login at this same site using your intern registration number as your login ID and the last 4 digits of your social security number as your password to purchase a card to be mailed to you or download the free copy for printing.
You may have your name changed on your registration at anytime by sending the official name change document (i.e. marriage certificate, divorce decree, court documents) to the Board office. This may be submitted with your paper renewal form, you may fax the document to the Board at 317.233.4236, or e-mail the document to pla4@pla.IN.gov; please include your registration number and how you want your name to read on your registration.
You must submit your change of address on your paper renewal application if it is different than what is listed on the renewal application.
You may also submit your change of address at any time online using LicenseExpress or by submitting a written notice to the Board. Your written notice must include your name, registration number, and both your old and new addresses; this notification may be sent by e-mail to pla4@pla.IN.gov or by fax to 317.233.4236.
If you have any questions, you may contact the Board office at pla4@pla.IN.gov.