Missouri Board of Pharmacy

Intern Pharmacist Licensure Application

$50

$80

By December 31 of even-numbered years.

Drug Distributor License Application--Out-of-State facility

$300

Online

$450

Annually by October 31.

Pharmacy Permit Application (Non-resident facility)

$300

• Business Entity State Tax Compliance Form: A “Business Entity State Tax Compliance Form” is included with this application.
  • The application will not be accepted without a Business Entity State Tax Compliance Form.
• Certificate of No Tax Due: Missouri law requires that any business being licensed by the state must provide a Certificate of No Tax Due from the Missouri Department of Revenue if the business engages in retail sales other than prescriptions. Certificates may be obtained at http://dor.mo.gov/business/sales/notaxdue/.
  • Questions about obtaining a Certificate of No Tax Due should be addressed to the Missouri Department of Revenue at (573) 751-9268.
  • Note: A Certificate is not required if the Business Entity State Tax Compliance Form is marked to identify that the applicant does not engage in the sale of goods at retail.
• State License: Provide a copy of the applicant’s pharmacy license issued by the state where the
  pharmacy is physically located. You are not eligible for licensure in Missouri if the facility is not licensed
  as a pharmacy or its equivalent by the state where the facility is located.
  • Pharmacist-in-Charge Statement: The statement must be signed and notarized by the
    designated pharmacist-in-charge.
  • Non-Resident Pharmacy License Verification Affidavit: An official Non-Resident Pharmacy Verification Affidavit form must be completed and officially sealed/certified by the state agency that regulates and licenses pharmacies in the applicant’s home state.
    • The top portion of the Affidavit should be completed by the applicant then forwarded to the licensing agency in the state where the facility is located.
    • Copies will not be accepted. Online printouts will not be accepted. RETURN THE COMPLETED VERIFICATION WITH THE APPLICATION.
  • Pharmacist License Verification Affidavit: Non-resident applicants must designate a pharmacist in charge that will be responsible for the supervision of the pharmacy.
    • The designated pharmacist-in-charge must be licensed as a pharmacist in Missouri or in the applicant’s home state.
    • A Pharmacist License Verification Affidavit form must be completed and sealed by the appropriate state agency that regulates and licenses pharmacists in the applicant’s home state.
    • Online printouts will not be accepted. RETURN THE COMPLETED VERIFICATION WITH THE APPLICATION.
  • Compounding and Internet Activity Statement: The statement must be completed, and
    signed by an owner or corporate officer.
  • Copy of state-controlled substance registration. Not required if your state does not issue a
    separate controlled substance registration or if the applicant will not dispense or distribute controlled
    substances in Missouri. Check the applicable box in Section A of this A application.
  • Copy of federal controlled substance registration. Not required if the applicant will not dispense
    or distribute controlled substances in Missouri. Check the applicable box in Section A of this Application.
  • Copy of most recent state pharmacy inspection. For applicants applying for a sterile compounding permit, the inspection must have occurred within the last eighteen (18) months. For all other pharmacy applicants, the inspection must have occurred within the last twenty-four (24) months. If a state inspection is unavailable, an inspection by the Missouri Board of Pharmacy or from the Verified Pharmacy Program (VPP) operated by the National Association of State Boards of Pharmacy may be submitted. Alternatively, the Board can accept an equivalent third-party inspection by an entity approved by the Board. Contact the Board office for approval of an inspection entity other than a state agency or NABP inspection.
  • Subscribe to Board’s electronic newsletter/e-alerts: The Board provides important regulatory news and licensing updates via its electronic newsletter and specially issued e-alerts. E-alerts include notice of disciplinary actions, including, actions against pharmacy technicians. Sign up for the Board’s newsletter and e-alerts online athttp://pr.mo.gov/pharmacists-newsletter.asp. 

Online

$450

Annually by October 31.

Drug Manufacturer Registrant Application

$10

Online

$10

Annually by October 31.

Examination Application

$150

Online

$200

By October 31 of even-numbered years.

Pharmacy Technician Registration Application

$35

Online

$35

Annually

Temporary Pharmacist License Application

$100

Third Party Logistics Provider Application

$300

Online

$450

Annually by October 31.