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License Transfer for Pharmacists

Applicant Information
Place of Birth
If not born in North Dakota, please select Out of State. If not born in the US, please select Out of Country.
Contact Information
Military Question
Are you a spouse of an active member of the military?
School Information
Certificates
Please indicate your Name and City as you want it to appear on your Original Certificate.

Any changes in the above information must be reported to the Board of Pharmacy Office immediately.