856 IAC 1-3.1-2 Information for licensure

Sec. 2. (a) Persons seeking licensure by examination shall file an application on a form supplied by the board. (b) Persons seeking licensure by examination shall provide the following information on, or submit such information with, the application for licensure: (1) Complete name, address, and telephone number. (2) Date and place of birth. (3) Certification of complete history and structure of hours of pharmacy experience prior to and after graduation. (4) Intern/extern certificate number, including date and state from which certificate was issued. (5) Two (2) recent passport-type (2"× 2") photographs of the applicant, taken within eight (8) weeks prior to filing the application. (6) The fee as required by 856 IAC 1-27-1. (7) Either: (A) certification of graduation from a program approved by the board pursuant to 856 IAC 1-5-1; or (B) in the case of an applicant applying in the last half-year of the curriculum, certification from the dean of an approved pharmacy program that the applicant is expected to successfully complete the curriculum; however, the applicant shall not be allowed to sit for the examination until the board has received certification of graduation.