Get Ca 17m-29 2018-2026

The CA 17M-29 form is crucial for those seeking licensure as a pharmacist in California. This guide will provide clear, step-by-step instructions on how to complete this form online accurately and efficiently.

Follow the steps to complete the CA 17M-29 form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Enter your full legal name in the designated field. This name must match your identification precisely to avoid processing delays.
3. Provide your contact information, including your mailing address, residence address, and phone numbers.
4. Indicate your date of birth and include your U.S. Social Security Number or Individual Taxpayer Identification Number (ITIN), which is mandatory.
5. Attach a recent, passport-style color photograph (2”x2”) that meets specifications set forth in the application instructions.
6. Fill in your educational details, including the name of the university or school of pharmacy and the degree obtained.
7. List all states where you have ever held a license as a pharmacist or other healthcare professional, ensuring to include any disciplinary actions on your record.
8. Self-Query Report from the National Practitioner Data Bank must be sealed and included with your application.
9. Complete the signatures and date the application, ensuring the signature is original and meets the specified time frame.
10. Once all fields are completed, save changes to the form. You can then download, print, or share your completed application as necessary.

Start filling out your CA 17M-29 form online now to take the next step toward your pharmacist licensure.