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Change of Ownership

Application for Pharmacy Permit
Application for Controlled Substance Registration

The Board shall change the ownership of a pharmacy permit for a facility that:

  1. submits a completed application for pharmacy permit and $50 application fee;
  2. submits a completed application for controlled substances registration and $100 application fee; and
  3. sets forth the name of the Indiana licensed pharmacist who will be in full responsible charge for the legal operation of the pharmacy (qualifying pharmacist; please make sure the named pharmacist is not listed as the "QP" on another pharmacy permit);

Fee Information
Applicants must submit a $50 pharmacy permit application fee and $100 CSR application fee (if applicable) in the form of a check or money order made payable to the "Professional Licensing Agency".  The fees may be combined into one check or money order.  The fee(s) must be submitted with the application to the following:

Professional Licensing Agency
402 W Washington Street, Room W072
Indianapolis, IN  46204.

What Do I Submit With The Completed Application for a Pharmacy Permit?
→ $50 pharmacy application fee and, if applicable, $100 CSR application fee;
→ drawing or blueprint showing physical size (include linear dimensions) and general layout of the floor plan; show the location of the prescription counter top with dimensions, location of the refrigerator, and prescription sink; 
→ if you answered “yes” to either of the Inquiry of Law Violations questions on page 3 of the application, then you must explain fully, including all related details, in a signed and notarized  statement.  You must also submit documentation regarding to the incident(s) in question.  
 
Upon receipt of all requested information, the Board office will issue a new permits with new license numbers.  The applicant will need to return the old pharmacy permit and CSR after the new ones are received.

Questions?
If you have any questions, please contact our office at pla4@pla.IN.gov.