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Get Third Party Prescription Program - License Renewal Application ... - Insurance Illinois
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How to fill out the Third Party Prescription Program - License Renewal Application - Insurance Illinois online
The Third Party Prescription Program - License Renewal Application is an essential document for administrators seeking to renew their licenses in Illinois. This guide provides clear, step-by-step instructions to help you fill out the application accurately and efficiently online.
Follow the steps to complete your application.
- Click ‘Get Form’ button to access the form and open it in your preferred editor.
- In the first section, enter the name of the Administrator for the Third Party Prescription Program as required.
- Provide the address (number and street) of the Principal Administrative Office, including the city, state, and zip code.
- Fill in the telephone number, ensuring to include the area code.
- Input the Tax, Social Security number, or License number as requested.
- Enter the business email address for communication regarding the application.
- Respond to the two critical questions regarding any felony convictions or past licensing issues. Ensure to check 'yes' or 'no' accordingly.
- If applicable, attach certified copies of any court documents related to convictions or previous license denials.
- Complete the declaration and certification section by signing and printing your name and the date below this statement.
- Lastly, review all entries for accuracy before saving changes, downloading, or printing the completed application.
Complete your Third Party Prescription Program - License Renewal Application online today.
Once your license expiration date has passed, you must reinstate your license. Go to NIPR Resident Licensing and apply for a license as a new license applicant. You will need to retake a pre-licensing education and exam, pay the application fees, and take your CE requirements.
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