Get Ga Application For Reinstatement/reactivation Of Pharmacy License 2023-2025

This guide provides a comprehensive overview of the steps required to fill out the GA Application For Reinstatement/Reactivation Of Pharmacy License online. Ensuring that you complete this form accurately is essential for a smooth reinstatement or reactivation process.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Indicate whether you are applying for reinstatement or reactivation by checking the corresponding box.
3. Fill in your full name in the designated fields: last name, first name, and middle name.
4. Provide your home address, including city, state, and zip code.
5. Enter your phone number and work number in the specified formats.
6. Include your email address, as this is how the Board will acknowledge your application and request any further information, if needed.
7. Insert your date of birth and Social Security number in the required fields.
8. Provide your Georgia pharmacy license number.
9. If you have been licensed in another state, request verification of your license from that state's Board of Pharmacy and ensure it is sealed and submitted with your application.
10. On a separate page, submit a Curriculum Vitae (C.V.) that outlines your work history since your license expired.
11. Answer whether you have practiced pharmacy since your license lapsed, providing specific dates and the name of the pharmacy where applicable.
12. Confirm if you have maintained your Continuing Pharmaceutical Education hours; attach copies of your proof of completion of the required 30 hours.
13. Disclose any misdemeanor or felony convictions, attaching relevant documentation if applicable.
14. Respond to questions regarding any license revocations or suspensions in other states, providing necessary documentation if needed.
15. Indicate if you are currently under investigation by any licensing board, attaching an explanation if applicable.
16. Answer questions about drug dependency or any physical or mental conditions that may affect your ability to practice pharmacy safely.
17. Review the application for accuracy and completeness, noting your responsibility to follow the rules and laws set forth by the Georgia State Board of Pharmacy.
18. Sign the application and include the necessary notary acknowledgment.
19. Prepare the application for submission, ensuring all documents are unstapled and unfolded, and send them in a 9 X 12 envelope.
20. Once you have completed the application, save your changes, download the document, print it for your records, or share it as needed.

Start your application process online today to ensure your pharmacy license is reinstated or reactivated with ease.