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Application for Pharmacy Permit The Board shall relocate a pharmacy permit for a facility that: Fee Information Professional Licensing Agency What Do I Submit With The Completed Application for a Pharmacy Permit? Updated License Card Questions?
Application for Controlled Substance Registration
Pharmacy Inspection Questions
Applicants must submit a $50 pharmacy permit application fee and $100 CSR application fee (if applicable) in the form of a check or money order made payable to the "Professional Licensing Agency". The fees may be combined into one check or money order. The fee(s) must be submitted with the application to the following:
402 W Washington Street, Room W072
Indianapolis, IN 46204.
→ $50 pharmacy application fee and, if applicable, $100 CSR application fee;
→ drawing or blueprint showing physical size (include linear dimensions) and general layout of the floor plan; show the location of the prescription counter top with dimensions, location of the refrigerator, and prescription sink;
→ if you answered “yes” to either of the Inquiry of Law Violations questions on page 3 of the 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.
Upon receipt of all requested information, the Board office will contact the individual listed on the application to schedule an inspection.
To receive an updated license card, you need to verify the address has been updated by using the "Search" function on our License Express website at http://www.in.gov/pla/license.htm. Upon verification of the update, you need to login at the "Order License Card" link to request and pay for a duplicate registration card. You will use the pharmacy permit number, including the "A" at the end (i.e. 6000XXXXA), as the login ID and password.
If you have any questions, please contact our office at pla4@pla.IN.gov.