Practitioner Controlled Substances Registration Application and Instructions

Application for CSR for Practitioners

An Indiana Controlled Substances Registration ("CSR") may be issued for one of the following practitioners:

1. physician,

2. osteopathic physician, 

3. veterinarian,

4. dentist,

5. podiatrist,

6. advanced practice nurse who meets the requirements of IC 25-23-1-19.5, or

7. physician assistant licensed under IC 25-27.5 and is delegated prescriptive authority under IC 25-27.5-5-6.

8. optometrist (Tramadol Only) who meets the requirements of IC 25-24-3-16.5.

The practitioner must hold an Indiana CSR and a federal Drug Enforcement Agency ("DEA") registration or is exempted from registration pursuant to 856 IAC 2-3-5(b) or 856 IAC 2-3-6 in order to prescribe, administer, or dispense controlled substances in the State of Indiana.

Active Indiana Practitioner License

Applicants must have an active Indiana practitioner license before they can obtain a CSR.  Practitioners must hold a CSR in order to prescribe, administer, store, dispense or otherwise handle controlled substances in the State of Indiana.  One CSR is sufficient for a practitioner to prescribe controlled substances throughout Indiana.  A separate registration is required for each location where a practitioner administers, stores or dispenses controlled substances, unless the practitioner does so under a facility's CSR in accordance with 856 IAC 2.

Indiana Practice Location

Applicants MUST use an Indiana practice address when applying for a CSR.  A CSR will only be issued to a street address; post office boxes are not acceptable.  An application with an incomplete or out of state address will be rejected. 

Controlled Substance Schedules to Request

Applicants may apply for authorization for Schedules II through V; a Schedule I controlled substance has no accepted medical use and are generally restricted to researchers only.

Application Instructions

A CSR may be issued to an applicant who submits the completed CSR application and $60 application fee.

If an applicant responds in the affirmative ("yes") to one of the questions on the application, then the applicant must explain fully, including all related details, in a signed and notarized statement.  You must also submit documentation regarding the incident(s) in question, this documentation includes the following:  court documentation that indicates charges, plea, sentencing requirements, and, if applicable, verification of completion of sentencing requirements; and any orders indicating action filed or taken against their DEA registration.

Application fee can be paid by check or money order, made payable to "Professional Licensing Agency".

Application, fee, and any other documentation required, must be submitted to the following:

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

Additional Information Pertaining to CSRs

Drug Enforcement Administration
Practitioners may apply for the Drug Enforcement Administration (DEA) registration after their Indiana CSR is issued.  The Professional Licensing Agency does not have DEA forms.  You must also apply for a federal Drug Enforcement Administration (DEA) registration by going to their website (http://www.deadiversion.usdoj.gov/). If you have further questions, you may contact the DEA at (317) 226-7977.

Renewals
Each registrant will receive renewal information for their CSR at the same time that he or she receives renewal information for his or her professional license with the Professional Licensing Agency.  Renewal information is sent 90 days prior to the expiration of the permit.  For additional renewal information, contact your individual licensing Board.

Continuing Education
Effective July 1, 2019, any licensed provider who applies for a controlled substance registration or renews a controlled substance registration must have two hours of continuing education in opioid abuse and prescribing to obtain or renew the registration. The two hours must be obtained within the previous two years prior to applying for or renewing a registration. Individuals applying for a controlled substance registration who have not yet received their professional license do not need to complete the two hours of CE. Providers applying for a controlled substance registration who already hold a professional license will need to submit proof of the two hours of continuing education with their application. Providers renewing a controlled substance registration will be asked to attest on their renewal that they have completed the two hours. These providers will then be subject to random audit. All providers should keep CE records for up to three years from the expiration date of the registration. Approved continuing education courses include any continuing education courses approved or provided by:

• United States Department of Education
• Council of Post-Secondary Education
• Joint Commission on Accreditation of Hospitals
• Joint Commission on Healthcare Organizations
• Federal, state, and local government agencies
• A college or other teaching institution accredited by the United States Department of Education or the Council on Post-Secondary Education
• A national organization of practitioners (ex. ADA, AMA)
• A national, state, district, or local organization that operates as an affiliated entity under the approval of a national organization of practitioners (ex. Indiana State Medical Association)
• An internship or residency program conducted in a hospital that has been approved by an organization listed above
• Any other organization or individual as may be approved by a provider's licensing board of the Indiana Board of Pharmacy

Address Change
Controlled substances registrations are issued for a particular purpose at a specified location.  Any change of address for practitioners must be reported to the appropriate licensing board.  The request for address change must be made in writing to our office by faxing 317.233.4236, e-mailing your individual licensing Board, or by mailing 402 W Washington Street Room W072, Indianapolis, Indiana, 46204.  Your written notice must include your name, license number, and both your old and new addresses.

To receive an updated license with your changed address, please verify that the address change has been completed by our office at http://www.in.gov/pla/license.htm.  Once it has been updated, you may request a duplicate license to be issued to you at the same website.  There is a $10 fee to receive a new license.

Name Change
If you have a legal name change and wish to change the name on your license, you will need to submit official documentation to verify the change.  This documentation includes a marriage license/certificate, social security card, or divorce decree.  The request for name change must be made in writing (including the official documentation) to our office by faxing 317.233.4236, e-mailing your individual licensing Board, or by mailing 402 W Washington Street Room W072, Indianapolis, Indiana, 46204.  Your name change request must include your license number and how you want your name to read on your license. 

To receive an updated license with your changed name, please verify that the name change has been completed by our office at http://www.in.gov/pla/license.htm.  Once it has been updated, you may request a duplicate license to be issued to you at the same website.  There is a $10 fee to receive a new license card.

Contact Information
For additional information regarding CSRs and/or the application process, please contact your individual licensing Board.