Get Ia Application For Resident And Nonresident Permanent Pic Change 2019-2025

Filling out the IA Application For Resident And Nonresident Permanent Pic Change is an essential step in managing pharmacist in charge changes at pharmacies. This comprehensive guide provides clear and supportive instructions to ensure that all necessary information is accurately submitted online, facilitating a smooth application process.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling in the licensee information section. This includes the name of the licensee, Iowa license number, and the legal name of the pharmacy. Ensure that all entries are typed or printed legibly.
3. Input the contact details for the pharmacy. Include the physical address, phone numbers, email address, and website, ensuring accuracy for correspondence.
4. In the PIC history section, provide the previous permanent PIC's name, Iowa license/registration number, and the date of vacancy. Indicate whether a new permanent PIC was identified at that time.
5. Complete the signatures section by having both the applicant and the new permanent pharmacist in charge sign the document. Date the signatures and ensure understanding of the application requirements.
6. If applicable, fill out the nonresident pharmacy PIC registration section, providing identification details and a list of licenses held in other states.
7. Review all completed sections for accuracy and completeness, referring back to the application checklist as needed.
8. Once all fields are completed, make necessary edits, save changes, and finalize your application for submission. You can download, print, or share the form as needed.

Complete your IA Application For Resident And Nonresident Permanent Pic Change online today for efficient processing.