Now Live: Easier Online License Applications and Renewals!
LicensE, our new, online, self-guided occupational license application platform is now live! The list of licenses available via LicensE plus user guides and other resources are available on the LicensE Customer Information page. Anyone applying for an initial license for any of the credentials listed can apply at license.wi.gov.
LicensE is also available for some license renewals. The list of license renewals available via LicensE is in the chart on the LicensE Customer Information page.
We are introducing a new LicensE Application Status Lookup tool. This tool will make it easier for employers to track the application status of current and future employees, and it will help academic advisors support students during the license application process. To access the Application Status Lookup tool, individuals will need an applicant's 10-digit PAR number. An applicant may provide the number to anyone who could support their application. For more information, see our press release.
ALERT - REMOTE DISPENSING SITES - Pursuant to
2021 Wis. Act 101, reflected in Wis. Stat. ch.
450, and Wisconsin Emergency Rule
EmR 2213, licensure requirements for remote dispensing sites have changed. Please refer to these documents for further information.
Wis. Stat. § 440.08 (2), the required renewal date for the Pharmacy (In-State) credential is 05/31/ each even-numbered year. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.
The completed application with the fee and required documentation must be submitted at least 30 days prior to date the applicant wishes to open the pharmacy. Make sure to provide all requested information.
The location of the pharmacy
A floor plan of the pharmacy. Enclose one set of original floor plans, scaled to size, with a description of the various areas designated. Indicate location of sink and refrigerator. For specific floor plan requirements refer to
Wis. Admin. Code ch. Phar 6.
The name of the managing pharmacist. Every pharmacy shall be under the control of the managing pharmacist who is listed on Department records. The managing pharmacist shall be responsible for the professional operations of the pharmacy. A pharmacist may be the managing pharmacist of not more than one community and one institutional pharmacy at any time and shall be engaged in the practice of pharmacy at each location he or she supervises. Use
Form 2516 to report changes in the managing pharmacist, to notify the Board of the supervision of remote dispensing sites pursuant to EmR 2213, or to request Board approval to supervise more than 10 remote dispensing sites.
Self-Inspection Report (Form 2550). This form must be completed and returned to the Department prior to opening.
To license a pharmacy where a change of ownership or change of location is involved, complete the steps above plus submit a Pharmacy Closing Affidavit (Form 606) completed and notarized by the former owner and forward it to the board office with the other required materials.
Register with the
Drug Enforcement Administration (DEA).
Application for Pharmacy (In State) Packet
609||Information for In-State Pharmacy (and Remote Dispensing Site) License Application|
1301||Instructions to Applicants for Pharmacy Change of Ownership/Location Change /Original Licensure (This form is available to determine if licensure is required.)|
3217||Application for Fee Reduction (Optional - This form
must accompany the application for the credential.)|
606||Pharmacy Closing Affidavit (This form is required to close a pharmacy and must be submitted within ten days of closure.)|
|1422||Pharmacy Self-Inspection Information Sheet |
|2550||Pharmacy Self-Inspection Report |
3085||Application for Predetermination (OPTIONAL-Submit
ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other
and you desire a review of your conviction record
before applying for a credential.)|
2252||Convictions and Pending Charges (if applicable)|
2556||Business Models and Requirements for Licensure (information regarding Out-of-State Pharmacy, Distributor, Manufacturer)|
2516||Managing Pharmacist Notification and Request Form (This form is required anytime a change in managing pharmacist occurs, to notify the Board of supervision of 5 to 10 remote dispensing sites, or to request prior Board approval to supervise more than 10 remote dispensing sites.)|
2661||Change of Name, Ownership, Location or Address for Pharmacy, Wholesale Distributor or Manufacturer (Instructions and Information)|
2866||Pharmacy Remodel Request Form |
2634||Pharmacy Remodel Request Information Sheet (Instructions for filing Remodel Request Form #2866)|
Procedures for Reporting DEA Theft or Loss of Controlled Substances
2691||Division of Enforcement Supplemental DEA Form for Reporting of Theft or Loss of Controlled Substances|
2821||Procedures for Reporting Theft or Loss of Controlled Substances (You will also need to contact the DEA and complete the DEA Form for Reporting a Theft or Loss of Controlled Substances.)|
2867||Pharmacy Variance Request Form and Information|
Pilot Program Forms
|Please click here for all Pilot Program Forms