Get A Permit Fee Of $200 Must Accompany This Application - State Of ...

Filling out the A Permit Fee Of $200 Must Accompany This Application is a crucial step for obtaining the necessary permits from the Oklahoma State Board of Pharmacy. This guide provides you with clear and detailed instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete your application online.

1. Click ‘Get Form’ button to access the application and open it for editing.
2. Fill in the name and/or doing business as (dba) of your facility along with the street address. Ensure you print clearly in the designated fields.
3. Provide your mailing address in the specified section. This address will be used for all correspondence regarding your permit.
4. Complete all required sections including ownership changes, address changes, and permit details. If not applicable, enter 'N/A'.
5. Indicate the types of prescription items sold or shipped to Oklahoma by checking all that apply in the section provided.
6. Enter a description of your business practice at the location, selecting all options that are relevant to your operations.
7. Fill in the facility hours, making sure to account for your operational schedule.
8. Specify the type of ownership for your business, choosing one of the provided options.
9. List the name of the partnership or corporate owner of the facility, along with the names of individual owners and partners or corporate officers. Use an additional page if necessary.
10. Answer the question regarding any disciplinary actions or convictions by indicating 'Yes' or 'No' and providing details on a separate page if applicable.
11. Confirm if the facility is located in Oklahoma. If not, attach the appropriate licensing documentation from the resident state.
12. Provide the name and title of the individual responsible for the application and ensure to sign and date the form.
13. Once all sections have been completed, save your changes. You may choose to download, print, or share the completed form as needed.

Complete your application online today to ensure timely processing of your permit.