bullred.gif (1398 bytes) Applications
bullred.gif (1398 bytes) pdf icon Board Information
bullred.gif (1398 bytes) Certification/Verificatoin
bullred.gif (1398 bytes) Complaints
bullred.gif (1398 bytes) Contact Us
bullred.gif (1398 bytes) Duplicate/Reissue
bullred.gif (1398 bytes) Fees
bullred.gif (1398 bytes) pdf icon Intern Hours Verification
bullred.gif (1398 bytes) License Lookup
bullred.gif (1398 bytes) Licensee Assistance Program
bullred.gif (1398 bytes) Listings
bullred.gif (1398 bytes) Name and Address Change

Pharmacist Intern
Applications

pdf icon The following links are in pdf format (if applications that are not available as links, please contact Claire at (402) 471-2118

pdf icon Application for Registration
pdf icon Affidavit of Pharmacy Hours
pdf icon Affidavit of Clinical Pharmacy Hours

These forms may be completed online, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form online, you must print the form and mail it to the address listed.

crldivider.gif (3455 bytes)

Professions and Occupations Home 

Licensure Unit Home

Documents in PDF PDF format require the use of Adobe Acrobat Reader which can be downloaded for free from Adobe Systems, Inc.