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Get Illinois Pharmacist In Charge Change Form

F the amount submitted is greater than the required fee hereunder, but in no event shall such reduction be made in an amount greater than $50. IL486-1398 10/04 (PH) Page 1 of 2 COUNTY OF ) AFFIDAVIT OF DEPARTING PHARMACIST-IN-CHARGE , first being placed on oath, deposes and says: 1. He/She has personal knowledge of the subject matter of this affidavit. 2. He/She has made or caused to be made an inventory of: all Schedule II drugs, as define.

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