Get Il Il486-0404 2014-2025

Filling out the IL IL486-0404 form for a pharmacy license can seem complicated, but this guide provides clear and easy-to-follow instructions. By following these steps, you can ensure your application is complete and avoid delays.

Follow the steps to complete your pharmacy license application online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by selecting the type of application you are submitting: establishing a new pharmacy, changing ownership, or changing the address of an existing pharmacy. Ensure each option selected aligns with your circumstances.
3. In the section titled 'Type of Pharmacy Operations', check all applicable boxes that describe your pharmacy operations, such as community pharmacy or nonresident pharmacy.
4. Enter the name of the partnership, corporation, or LLC that will own the pharmacy. If you are a sole proprietor, indicate this by entering N/A.
5. Provide the doing business as (DBA) or assumed name of the pharmacy in the designated field.
6. Input the name and license number of the pharmacist-in-charge who will oversee pharmacy operations.
7. Fill in the complete address of the pharmacy, including street number, suite number (if applicable), city, state, and ZIP code.
8. Include the county where the pharmacy is located and provide a contact telephone number with the area code.
9. For additional ownership details, supply the name and title of the designated partner or corporate officer, along with their home address and Illinois license number.
10. Confirm ownership of the pharmacy by checking the appropriate box, such as pharmacist sole proprietor or corporation, and provide details about the owners.
11. If applicable, complete the sections for non-resident pharmacies, including the current state and various license numbers.
12. Complete all areas that apply based on your specific application, including previous pharmacy names and addresses if changing ownership or location.
13. Ensure all supporting documents are ready for submission, such as articles of incorporation, annual reports, or proof of business name registration.
14. Review the application thoroughly to verify all information is accurate and complete.
15. Finally, save your changes, download a copy for your records, and print the completed form before submitting it along with the required fees to the indicated address.

Start completing your pharmacy license application online today!