APPLICATIONS AND FORMS Do not submit both an online and paper application. Submitting duplicate applications creates more work for staff and causes significant delays in processing applications. Emailed applications will not be accepted. Notice Please read the FAQs and statutes and regulations prior to applying for licensure. It is your responsibility to understand all application requirements prior to submitting any documentation. Online Applications Now available for the following: Pharmacist by Exam Pharmacist by Reciprocity Pharmacy Technician Pharmacy Intern Pharmacy Click Here to Apply Online Online applications are filed through your MyAlaska account. Filing via the MyAlaska account allows for email notifications about your application status. Please review the instructions for filing an Initial Application online via MY LICENSE. Paper Applications Emergency Permit The emergency permit is to be used to respond to an urgent situation, which is defined in 12 AAC 52.110. 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 Application#08-4888, Revised 02/27/2024 Pharmacists, Technicians, and Interns Pharmacist by Exam or Reciprocity Application#08-4032, Revised 11/05/2024Application of pharmacist licensure by examination, by score transfer, or by credentials through NABP. Retired Pharmacist Application#08-4882, Revised 11/05/2024 Pharmacy Intern Application#08-1468, Revised 03/18/2025Application for licensure as a pregraduate or postgraduate. License required before beginning an internship in the state. Pharmacy Technician Application#08-4353, Revised 11/05/2024License required before beginning employment as a technician. Physician-Pharmacist Cooperative Practice Agreement#08-4410, Revised 09/28/2023 Change of Pharmacist-in-Charge (PIC) or Designated Representative#08-4064, Revised 01/08/2025 Questions? Review the FAQs found here. Facilities Pharmacy License Application#08-4082, Revised 03/18/2025 Remote Pharmacy License Application#08-4045, Revised 10/10/2025Application for a remote pharmacy located inside the state. Drug Room License Application#08-4185, Revised 10/10/2025Application for drug room located within an institutional facility. Wholesale Drug Distributor License Application#08-1466, Revised 10/10/2025 Outsourcing Facility License Application#08-4813, Revised 10/10/2025 Third-Party Logistics Provider License Application#08-4814, Revised 10/10/2025 Manufacturer License Application#08-4990, Revised 10/10/2025 Shared Pharmacy Services Application#08-4566, Revised 10/10/2025 Renewal Applications Renewal applications will be available no later than May 31, 2026, in accordance with AS 08.01.050. Please note, you must wait for an updated renewal application to renew your license. You cannot renew your license using any prior renewal forms. If you need to renew your license for the current licensing period (expired on 6/30/2026), email BoardofPharmacy@Alaska.Gov to request the appropriate form. To ensure receipt of renewal notifications and other correspondence from our office, please go to MY LICENSE and confirm your current mailing address is on file. Reinstatement Application Reinstatement of 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 01/05/2026 Remote Pharmacy Self-Inspection Report#08-4442, Revised 01/05/2026 Facility Self-Inspection Report#08-0098, Revised 01/05/2026 Drug Room Self-Inspection Report#08-4043, Revised 01/05/2026 Miscellaneous Forms 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 01/08/2025 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 Return to Top