Board of Pharmacy Initial Applications Pharmacists, Technicians, and Interns Pharmacist Application #08-4032, Revised 05/15/14. Application of pharmacist licensure by examination, by score transfer, or by credentials through NABP. Pharmacy Intern Application #08-1468, Revised 02/10/18. Application for licensure as a pregraduate or postgraduate. License required before beginning an internship in the state. Pharmacy Technician Application #08-4353, Revised 05/15/14. License required before beginning employment as a technician. Pharmacist Collaborative Practice Application #08-4410, Revised 06/22/06. Intern Affidavit of Experience #08-4068, Revised 02/13/07. Questions? See the Guide to Obtaining Your Alaska Pharmacist License Facilities In-State Pharmacy License Application #08-4082, Revised 05/15/14. Application of pharmacy located in the state. Pharmacy Self-Inspection Report #08-4150, Revised 04/05/14. Print in landscape format. Remote Pharmacy License Application #08-4045, Revised 05/15/14. Application for a remote pharmacy located inside the state. Remote Pharmacy Self-Inspection Report #08-4442, New 05/08/06. Wholesale Drug Distributor Application #08-1466, Revised 05/15/14. Application for facility located in the state. Wholesale Drug Distributor Self-Inspection Report #08-0098, Revised 05/05/06. Drug Room License Application #08-4185, Revised 05/15/14. Application for drug room located within an institutional facility. Drug Room Self-Inspection Report #08-4043, Revised 05/05/06. Shared Pharmacy Services Application #08-4566, Revised 01/10/12. Out-of-State Out-of-State Application #08-4200, Revised 05/15/14. Application of out-of-state pharmacy providing prescription drugs and devices to Alaska residents. Out-of-State Pharmacy Self-Inspection Report #08-4607, Revised 04/05/14. Change of Pharmacy Manager Notice #08-4064, Revised 04/02/12. Annual Information Update #08-4484, Rev. 04/10/17. Out of State Wholesale Drug Distributors General Information The Alaska Board of Pharmacy requires registration of a pharmacy located outside of the state ONLY if the pharmacy ships, mails or delivers prescription drugs to consumers in the state (AS 08.80.158). A license as a wholesale drug distributor is required for a facility engaged in wholesale distribution of drugs or related devices from a site in Alaska. A facility engaged only in wholesale operations at a site outside of Alaska is not required to register with the Alaska Board of Pharmacy. The facility must be registered in the jurisdiction where the facility is located, and must be registered with the DEA if distributing controlled substances. The facility must comply with all applicable statutes and regulations. An out of state license is required for a pharmacy located outside of the state that is providing prescription drugs directly to patients in Alaska. You can find all the pertinent applications, fee information, regulations and statutes at our website. The link is ProfessionalLicense.Alaska.Gov/BoardOfPharmacy When applying for a business license, you may be using one or both of the following activity codes: 424210 – Drug Wholesalers 423490 – Professional Equipment Wholesalers If you have questions about business licensing specifically, please call them directly at (907) 465-2550. Renewal Applications Pharmacists and Technicians Biennial Pharmacist License Renewal Application #08-4096, Revised 04/28/16. Biennial Pharmacy Technician License Renewal Application #08-4306, Revised 04/28/16. Facilities In-State Biennial Pharmacy License Renewal Application #08-4553, Revised 04/22/16. Biennial Remote Pharmacy License Renewal Application #08-4552, Revised 04/22/16. Biennial Wholesale Distributor License Renewal Application #08-4554, Revised 04/22/16. Biennial Pharmacy Drug Room License Renewal Application #08-4097, Revised 04/22/16. Out-of-State Biennial Out-of-State Pharmacy License Renewal Application #08-4555, Revised 04/22/16. Miscellaneous Forms Reinstatement of a Pharmacist License Job Shadowing Documentation Pharmacy Intern Jurisprudence Exam Change of Pharmacy Manager Change of Name, Address, and/or Duplicate License Request for License Verification Order a Wall Certificate Credit Card Authorization Form 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.