Pharmacy (In-State) – Change of Ownership

You have an existing In-State Pharmacy license that has recently undergone a change in ownership.

Below are some general instructions for applying for a credential on LicensE. 

1. Create or log into your LicensE account. Please visit LicensE account Information page for detailed guidance on selecting your account type.

2. Select "Apply for a License."

3. Select your Category.

4. Select your License Type.

5. Select your Application Method, then "Next."

6. Review your Personal Information.

7. Enter the requested Information on each page of the application. Information may include Examination, Education, or License History, depending on your profession.

8. If applicable, request a Veterans Fee Waiver or Initial Credential Fee Reduction.

9. Submit the requested Documents you may already have. You do not need to have all documents ready to submit.

   Note: Forms are now hosted on AccessGov. Visit AccessGov Forms Directory to choose your form.

10. Respond to the Attestation questions.

11. Provide Payment Information. Fees may be found Credential Fees.

12. Submit your application.  

Profession specific application requirements can be found in the "Application Information" section.

1. Login to your organization LicensE account

2. Category: Health

3. License Type: Pharmacy (In-State)

4. Application Method: General Licensure

5. Submit your Business Information

6. Submit your Managing Pharmacist information

7. Submit your Pharmacy Hours

8. Submit your Sundry Hours

9. Submit your Authorization

10. Respond to the Declarations

11. Submit your Inspection information

12. Submit the requested Documents you may already have. You do not need to have all documents ready to submit and initiate the application.

13. Respond to the Attestations

14. Provide Payment Information. Fees may be found (Link fee page)

15. Submit your application

Please note that applicants must contact the Federal Drug Enforcement Administration for registration forms at www.deadiversion.usdoj.gov, (312) 353-1236, DEA, 230 South Dearborn Street, Ste. 1200, Chicago, Illinois 60604.

• Form 2550: Self-Inspection Report

  Please note that this form must be completed and returned to the Department prior to the opening of an In-State Pharmacy.

• Form 606: Pharmacy Closing Affidavit (If you are submitting an application for Change in Location or Change in Ownership) Please note that Form 606 can be submitted after the license is issued.

• Original floor plans

  Prepare and submit one set of original floor plans, scaled to size, with a description of the various areas designated. Please indicate location of sink and refrigerator.(For specific floor plan requirements, please refer to Wisconsin Administrative Code ch. Phar 6 pharmacy licenses and equipment.)

• A statement specifying if this application is for a change of ownership of an existing WI license. You must include the previous WI license number and the proposed opening date for the new location.

• Form 2516: Managing Pharmacist Notification and Request Form

• Form 225X: Convictions and Pending Charges

  Please note that Convictions and Pending Charges (Form 225X) is required if the managing pharmacist listed in the application has ever been convicted of a misdemeanor, felony, or other violation of federal or state law or if he or she has any felony, misdemeanor, or other violation of federal or state law charges pending against him or her in this state or any other. This includes convictions resulting from a plea of no contest, a guilty plea, or verdict.

• If required, upload Form 225X and required documentation into LicensE. Pay the associated additional $8.00 fee in LicensE.

• Form 2829: Malpractice Suits or Claims Form

Next steps may be found below, in the “What Happens Next?” section.

After you upload all required documents, submit your application, and pay the required fee(s):

1. Preliminary Application Reference Number (PAR)

   1. Your application will be assigned a Preliminary Application Reference number or PAR number. This number allows you and trusted parties to look up the status of your application without logging in. You can also reference this number in any support tickets you submit in regard to your application.

      • A trusted 3^rd party can look up your credential status by visiting LicensE, clicking “Application Status Lookup” and entering the PAR number you have provided to them.

2. Review Timeline

   1. Your materials will be reviewed within approximately 10 days by a member of the credentialing team.

      • Note: Some licenses do take longer to process due to complexity. You can see the performance data on our LicensE Dashboard to see what date we are reviewing for certain application types under "Application Review Times by Profession."

3. Pending Applicant Input Status

   1. After this review, if anything is missing or the credentialing team has any questions on your application, your application will go back into a status called “Pending Applicant Input.”  You will receive an email letting you know your application was moved into this status. You should then log into LicensE and check your application “Due Diligence.”

4. To check your "Due Diligence" 

   1. Your Due Diligence is a checklist of items required for your credential.

   2. The Due Diligence section is how DSPS staff will communicate with you regarding your credential requirements.

   3. Log in to your LicensE account

   4. Click on "Check Application Status" 

   5. Your credential application should be shown on this page. Under “Action” select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop.

   6. After clicking the upside-down triangle, select “View Due Diligences.”

   7. The Due Diligence column lets you know what the requirement is.

   8. The “STATUS” column will you know if the item is “Met”, “Not Met”, or “Not Applicable.”

      • Items listed as “Not Met” are items that are needed by the Department.  

   9. The “NOTES” column of your Due Diligence will provide further written details or instructions about what is still needed.

5. To upload documents

   1. Some applications require additional document uploads.

   2. Log into your LicensE account

   3. Click on "Check Application Status"

   4. Your credential application should be shown on this page. Under "Action" select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop. 

   5. After clicking the upside-down triangle, select "Upload Document."

   6. The document must be an allowable document type. 

   7. After uploading the document, click "submit." If you do not, it will not be sent to a reviewer. 

6. If you have any questions, you can submit a support ticket on LicensE by logging in and clicking "request support" at the top of the page.

LicensE statuses that require action from applicant:

LicensE statuses that indicate the application is with Department staff:

Support Ticket
Submit a support ticket on LicensE and click "request support." Please provide as much detail as possible regarding your concern so we can work to answer your question with a one touch resolution. 

Call
608-266-2112

Email
dsps@wisconsin.gov

Office Hours
7:45am-4:30pm
Department of Safety and Professional Services
4822 Madison Yards Way
Madison, WI, 53705

Note: The in-person office does not process same day.