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  • Az Certificate To Dispense Form

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State of Arizona Naturopathic Physicians Medical Board 1400 W Washington Ste. 300 Phoenix AZ 85007 Phone 602-542-8242 Fax 602-542-8804 www.aznd.gov CERTIFICATE TO DISPENSE APPLICATION Please Print.

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CHANGE OF ADDRESS / NAME / ENTITY MARION COUNTY, KENTUCKY CALDWELL COUNTY, KENTUCKY OCCUPATIONAL TAX Registrationformrunforwellness - Mary Mediatrix Medical Center

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Arizona law (A.R.S. §32-1871) requires that you register with the Board if you dispense prescription-only drugs or devices (excluding samples) to your patients from your office, clinic, or practice location. This law applies only to doctors practicing in Arizona, not to doctors practicing out of state.

As a physician, you will already have a state license to practice. You will also need to secure a Drug Enforcement Administration (DEA) number that will allow you to write and hand out prescriptions, especially of regulated medications.

Physician dispensing means the delivery of a controlled substance, a prescription only drug, or a prescription-only device to a patient outside the physician's office. Health Professionals that can dispense medication in Arizona include: **Medical Doctors (MD) *Clinical Nurse Specialist (CNS)

Physician dispensing—also known as in-house dispensing—is the practice of providing prescription drugs directly to patients from your office or clinic instead of writing a prescription and sending them to a pharmacy.

The prescription order shall not be filled or refilled more than six months after the date on which the prescription order was issued. A prescription order authorized to be refilled shall not be refilled more than five times.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232