Board of Pharmacy Do not email applications containing social security numbers or credit card information. Emergency Applications The emergency permit is to be used to respond to an urgent situation, which is defined in 12 AAC 52.110. Please do not submit a Pharmacy Emergency Permit Application without first contacting the Executive Administrator for the Alaska Board of Pharmacy, Michael Bowles at (907) 465-1073 to discuss the situation warranting an Emergency Permit. Pharmacy Emergency Permit Applications will only be considered for a “health crisis” as outlined in the Board of Pharmacy statutes and regulations or Alaska Department of Health, or an acute situation where public health and safety may be affected. The State of Alaska’s Department of Health does not currently have any declared public health emergencies. Emergency PERMIT Emergency Permit, Paper Application#08-4888, Revised 02/27/2024 Emergency Permit, Online Application Emergency permit applicants: download the instructions HERE. Initial Applications Pharmacists, Technicians, and Interns Please do not submit both an online and paper application. Submitting duplicate applications creates more work for staff and causes significant delays in processing applications. Pharmacist by Exam, Online ApplicationFiled through myAlaska account. Online Application Instructions & Forms Pharmacist by Reciprocity, Online ApplicationFiled through myAlaska account. Online Application Instructions & Forms Pharmacist by Exam or Reciprocity, Paper Application#08-4032, Revised 05/19/2024Application of pharmacist licensure by examination, by score transfer, or by credentials through NABP. Retired Pharmacist Application#08-4882, New 01/20/2024 Pharmacy Intern Application#08-1468, Revised 02/22/2024Application for licensure as a pregraduate or postgraduate. License required before beginning an internship in the state. Pharmacy Technician, Online ApplicationFiled through myAlaska account. Online Application Instructions & Forms Pharmacy Technician, Paper Application#08-4353, Revised 05/08/2024License required before beginning employment as a technician. Affidavit of Experience Physician-Pharmacist Cooperative Practice Agreement#08-4410, Revised 07/08/2022 Change of Pharmacy Manager Notice#08-4064, Revised 05/26/2022 Questions? Review the FAQs found here. Facilities Please do not submit both an online and paper application. Submitting duplicate applications creates more work for staff and causes significant delays in processing applications. Facility License Application#08-4865, Revised 04/16/2024 Pharmacy License Application#08-4082, Revised 10/11/2023 Remote Pharmacy License Application#08-4045, Revised 10/11/2023Application for a remote pharmacy located inside the state. Drug Room License Application#08-4185, Revised 04/11/2023Application for drug room located within an institutional facility. Shared Pharmacy Services Application#08-4566, Revised 01/10/2012 Renewal Applications Pharmacists and Pharmacy Technicians: Do not sign or date your renewal form until you have completed your continuing education requirements. This requirement is clear in the text above the signature line on pharmacist and technician renewal forms. CEs completed after the date on your renewal form will be disregarded in an audit. The envelopes and postmark dates used for division correspondence become part of your permanent record. Late renewal applicants must submit proof of completing the required continuing education (CE) activity by attaching copies of CE certificates of completion to the renewal application. Pharmacists and Technicians It is Time to Renew Your License! Click Here to Renew Online Renewal Instructions Payment and Refund Policy Renewal Applications Pharmacist License Renewal Application#08-4096, Revised 04/16/2024 Pharmacy Technician License Renewal Application#08-4306, Revised 04/16/2024 Facilities Pharmacy License Renewal Application#08-4889, Revised 04/16/2024 Remote Pharmacy License Renewal Application#08-4552, Revised 04/16/2024 Wholesale Distributor License Renewal Application#08-4554, Revised 04/16/2024 Pharmacy Drug Room License Renewal Application#08-4097, Revised 04/16/2024 Facility License Renewal Application#08-4890, Revised 04/16/2024 Reinstatements Reinstatement of a Pharmacist License#08-4225, Revised 10/11/2023Reinstatement applications are only used for Pharmacist licenses that have been lapsed more than 2 years but less than 5 years. Self-Inspection Reports Pharmacy Self-Inspection Report#08-4150, Revised 07/06/2020 Remote Pharmacy Self-Inspection Report#08-4442, Revised 07/06/2020 Facility Self-Inspection Report#08-0098, Revised 11/03/2022 Drug Room Self-Inspection Report#08-4043, Revised 07/06/2020 Miscellaneous Forms Letter of Explanation for a Professional Fitness "Yes" Answer#08-4752, Revised 11/15/2021 Request for Expedited Review of Healthcare Professional Application#08-4664, Revised 12/28/2023 The following forms may also be initiated online via the MY LICENSE self-service portal. Cessation of Facility Operations#08-4791, Revised 01/30/2023 PDMP Dispensing Status Change Form for Pharmacists#08-4840, New 03/17/2022 PDMP Dispensing/Distributing Status Change Form for Pharmacies#08-4841, New 03/17/2022 Please Note: We no longer require a form to be completed for changes to pharmacists-in-charge or designated representatives. A pharmacist designated to replace the pharmacist-in-charge of a licensed pharmacy, including both in state and out of state pharmacies, shall notify the board in writing (this can be either email or letter) not later than 30 days after that designation. A designated representative of a wholesale drug distributor, outsourcing facility, third-party logistics provider, or manufacturer designated to replace an outgoing designated representative of a facility shall notify the board not later than 30 days after that designation, by submitting a completed change of designated representative notice in writing (this can be either email or letter). The outgoing designated representative shall also notify the board in writing not later than 30 days after departure. Return to Top