Pursuant to
2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out
Form #3085 and submit all required documentation specified on the form. Pursuant to
Wis. Stat. §
111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.
License Information
Fee Reduction
Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.
Per
Wisconsin State Statutes 440.08 (2), the required renewal date for the Pharmacy (Out of State) credential is 05/31/even years. 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.
- Complete and submit the Application for Pharmacy (Out-of-State) with required forms and fee.
- Register with the
Drug Enforcement Administration (DEA).
- Department review of application; determination whether to grant credential.
No pharmacy that is in another state may ship, mail, or otherwise deliver a prescribed drug or device to persons in Wisconsin unless the pharmacy is licensed in Wisconsin.
An out-of-state pharmacy that applies for a license is not required to comply with Wisconsin law relating to the professional service area of a pharmacy or the minimum equipment requirements for a pharmacy.
A pharmacist employed in an out-of-state pharmacy is not required to be licensed in Wisconsin.
A licensed out-of-state pharmacy is not required to be under the control of a managing pharmacist licensed in Wisconsin.
A licensed out-of-state pharmacy shall provide a telephone number that allows a person in Wisconsin to contact the pharmacy during the pharmacy's regular hours of business and that is available for use by a person in Wisconsin for not less than 40 hours per week.
The label of all prescription drug containers shipped, mailed, or otherwise delivered to a person in Wisconsin must bear the telephone number of the out-of-state pharmacy.
Application for Licensure
| Form | Description |
|---|
|
2737 | Application for Out-of-State Pharmacy Form (Out-of-State Pharmacies that have a change in Managing Pharmacist, should notify DSPS on company letterhead of the change. Please submit to
dspscredpharmacy@wisconsin.gov) |
| 3217 | Application for Fee Reduction (This form must accompany the application for the credential) |
|
3085 | Application for Predetermination |
|
2252 | Convictions and Pending Charges |
|
3071 | Fax Payment Form |
Profession Forms
| Form | Description |
|---|
|
2661 | Pharmacy, Distributor, or Manufacturer Change of Ownership Form (if Re-Licensure is required, you must re-complete Form #2737) |