Application for Internship Licensure

Application Instructions

• Complete all required information on the form. Make sure all information is complete and accurate to prevent any delays in processing.
• Upload a recent photo for identification.
• Submit the form.
• If applicable, your application will need to be approved electronically by your preceptor pharmacist. An email will be generated to the pharmacist based on the email provided on the application.
• If your application is approved, you will be receive an email directing you to the form to pay your $10.00 registration fee. This fee must be paid by credit/debit card.
• Once the application and fee have been reviewed, your registration will be approved and emailed to you at the email address that you provided on the application
• If you have any questions during the process, don’t hesitate to contact the Board office, 701-877-2404.