R4-18-903. Application for a Certificate to Dispense; Renewal

A. An applicant for a certificate to dispense shall submit: 1. An application to the Board that contains: a. The applicant’s: i. Full legal name; ii. Naturopathic license number, if known; and iii. Social Security number; b. If a corporation, a statement of whether the corporation holds tax exempt status; c. A statement of whether the applicant holds a drug enforcement number issued by the United States Drug Enforcement Administration, and if so, the drug enforcement number; d. A statement of whether the applicant has ever had the authority to prescribe, dispense, or administer a natural substance, drug, or device limited, restricted, modified, denied, surrendered or revoked by a federal or state agency or court of law, and if so, an explanation that includes: i. The name and address of the federal or state agency or court having jurisdiction over the matter, and ii. The disposition of the matter; e. A statement, signed by the applicant, that the applicant agrees to conform to all federal and state statutes, regulations, and rules; and f. The date the application is submitted; and 2. Unless exempted by A.R.S. § 32-1530, the fee required by the Board. B. A certificate holder shall renew a certificate to dispense on or before July 1 of each year by submitting: 1. An application to the Board that contains: a. The applicant’s full legal name; b. If a corporation, a statement of whether the corporation holds tax exempt status; c. A statement of whether the applicant has had the authority to prescribe, dispense, or administer a natural substance, drug, device limited, restricted, modified, denied, surrendered or revoked by a federal or state agency or court of law, during the one year period immediately preceding the renewal date and if so, an explanation that includes: i. The name and address of the federal or state agency or court having jurisdiction over the matter; and ii. The disposition of the matter; and d. A statement, signed and dated by the applicant, verifying the information on the application is true and correct and the applicant is the licensee named on the application; and 2. Unless exempted by A.R.S. § 32-1530, the fee required by the Board. C. The Board shall grant or deny the certificate to dispense or renewal of certificate to dispense according to the time-frames in Article 7, Table 1 of this Chapter.