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Get Pa 854 143 2016-2025
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How to fill out the PA 854 143 online
Filling out the PA 854 143, also known as the Nonresident Pharmacy Application, is a crucial step for pharmacies wishing to register in Pennsylvania. This guide will walk you through the process step-by-step to make the online experience clear and efficient.
Follow the steps to successfully complete the application online.
- Click ‘Get Form’ button to access the form and open it in the editing tool.
- Begin completing the application by selecting the transaction type that applies to your situation. Check the appropriate box for new nonresident pharmacy registration, change in location, ownership, or title, and note the applicable fee.
- Fill in the name of the pharmacy as it is registered in your resident state. Ensure that this information matches exactly with the pharmacy permit.
- Provide the pharmacy permit/license number from your resident state, ensuring it again matches the necessary documentation.
- Enter the pharmacy's address as registered in your resident state, including street, city, state, and zip code.
- If there is a change in location, complete the section with the former pharmacy address and the relocation date, along with documentation supporting the change.
- For a change in title, indicate the former title and effective date of the change, alongside the necessary documenting evidence.
- In the case of ownership change, provide the former owner's name and the effective date of this change. Ensure to complete the ownership information section as required.
- After completing all necessary sections, review your application for accuracy. You must sign the verification statement, affirming the truthfulness of the information provided.
- Once all information is complete and reviewed, submit your application and the required fee. Make arrangements for mailing or submitting your application and supporting documents to the Pennsylvania State Board of Pharmacy.
Start filling out your PA 854 143 application online today!
Applying for a PA pharmacist license involves several key steps. First, you must complete the application form and submit supporting documents, including proof of education and passing exam scores. It's essential to stay informed about the latest requirements, which can change. Utilizing platforms like USLegalForms can streamline your application process with accurate forms and guidance tailored to PA 854 143.
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