Board of Pharmacy Emergency Applications The emergency courtesy license 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 #08-4032f, Revised 01/30/2023 Emergency Permit, Online Application Initial Applications Pharmacists, Technicians, and Interns Pharmacist Application Emergency permit applicants: download the instructions HERE. #08-4032, Revised 01/30/2023 Application of pharmacist licensure by examination, by score transfer, or by credentials through NABP. Pharmacy Intern Application #08-1468, Revised 01/30/2023 Application for licensure as a pregraduate or postgraduate. License required before beginning an internship in the state. Applications submitted on or after 10/31/2019 no longer require a declaration of sponsorship form to be completed. In addition, individuals wishing to practice within the scope of a pharmacy intern must be licensed in Alaska prior to engaging in an internship. Pharmacy Technician, Online Application Filed through MyAlaska account. Online Application Instructions & Forms Pharmacy Technician, Paper Application #08-4353, Revised 05/19/2023 License required before beginning employment as a technician. Physician-Pharmacist Cooperative Practice Agreement #08-4410, Revised 07/08/2022 Intern Affidavit of Experience #08-4068, Revised 08/07/2019 Questions? Review the FAQs found here. Facilities In-State Facility License Application #08-4865, New 07/14/2023 Pharmacy License Application #08-4082, Revised 01/30/2023 Application of pharmacy located in the state. Remote Pharmacy License Application #08-4045, Revised 12/12/2019 Application for a remote pharmacy located inside the state. Drug Room License Application #08-4185, Revised 04/11/2023 Application for drug room located within an institutional facility. Shared Pharmacy Services Application #08-4566, Revised 01/10/2012 Out-of-State Facility License Application #08-4865, New 07/14/2023 Out-of-State Pharmacy Application #08-4200, Revised 01/30/2023 Application for an out-of-state pharmacy providing prescription drugs and devices to Alaska residents. 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 Biennial Pharmacist License Renewal Application #08-4096, Revised 08/10/2022 Biennial Pharmacy Technician License Renewal Application #08-4306, Revised 05/19/2023 Reinstatement of a Pharmacist License #08-4225, Revised 12/06/2022 Reinstatement applications are only used for Pharmacist licenses that have been lapsed more than 2 years but less than 5 years. Facilities In-State Biennial Pharmacy License Renewal Application #08-4553, Revised 08/10/2022 Biennial Remote Pharmacy License Renewal Application #08-4552, Revised 08/10/2022 Biennial Wholesale Distributor License Renewal Application #08-4554, Revised 08/10/2022 Biennial Pharmacy Drug Room License Renewal Application #08-4097, Revised 08/10/2022 Out-of-State Biennial Out-of-State Pharmacy License Renewal Application #08-4555, Revised 08/10/2022 Biennial Third-Party Logistics Provider License Renewal Application #08-4743, Revised 08/10/2022 Biennial Outsourcing Facility License Renewal Application #08-4744, Revised 08/10/2022 Biennial Wholesale Distributor License Renewal Application #08-4554, Revised 08/10/2022 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 Out-of-State Pharmacy Self-Inspection Report #08-4607, Revised 12/06/2022 Miscellaneous Forms IHS Pharmacist State Licensure Exemption #08-4826, New 11/04/2019 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 04/17/2023 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.