Skip to form

Department of Inspections, Appeals, and Licensing

amanda.woltz@dia.iowa.gov

6200 Park Ave., Ste. 100 Des Moines, IA 50321

Main Line: 515.281.5944 Fax: 515.281.4609

Iowa Board of Pharmacy Contact Form

Full Name

Full Address

To report changes to your license or registration that do not require an application and fee, please identify the license type for which you are reporting a change and provide the following required information in the “Message” box below:

  • Individual licensee/registrant (pharmacists, interns, technicians, PSPs, CSA-Individuals) reporting a change of address, email, phone, or employment 
    • provide the updated information and date of the change within 30 days of the change
  • Nonresident Pharmacist in Charge reporting any change to the home state pharmacist license
    • provide the relevant updated information and date of the change within 30 days of the update to the home state
  • Nonresident pharmacy reporting change of PIC
    • provide the new PIC’s full name and Iowa NRP PIC Registration Number (or Iowa Pharmacist License number) within ten (10) days of the change
  • Iowa-located pharmacy reporting change of PIC
    • provide the new PIC’s full name and Iowa Pharmacist License number within 30 days of the change
  • Pharmacy reporting change of ownership
    • provide the name, address, and contact information (including phone and email) for the new owner within 30 days of the change
  • CSA-Business registrant (except Wholesale Distributor, 3PLs, Outsourcing Facility) reporting change of ownership or responsible individual
    • provide the full name, address and contact information (including phone and email) for the new owner or responsible individual within 30 days of the change
  • CSA-Business registrant reporting a change to the substances authorized
    • provide the updated schedules of substances to be handled by the registrant (specifying “N” for non-narcotic schedules when appropriate)
  • Wholesale Distributor or Third-Party Logistics Provider reporting the identification of a temporary facility manager or the change of business type or ownership
    • provide the full name, address, and contact information (including phone and email) for the temporary facility manager or new owner or the new business type within 30 days of the change
  • Outsourcing Facility reporting the identification of a temporary supervising pharmacist or the change of ownership
    • provide the full name, address, and contact information (including phone and email) for the temporary supervising pharmacist or owner within 30 days of the change
  • Limited Distributor reporting a change of facility manager, business type, or ownership
    • provide the full name, address, and contact information (including phone and email) for the new facility manager or owner or the new business type within 30 days of the change 

Reason for Contact

Receipt

You will be provided with a Receipt upon submission.