Applications and Forms
Please Note the following: If you have been previously licensed in Massachusetts as a Registered Pharmacist or Pharmacy Technician and want to renew your EXPIRED or LAPSED license, you must call the Board of Registration in Pharmacy office directly at 617-973-0960. DO NOT use one of the following applications.
Professional Credential Services - The Massachusetts Board of Registration in Pharmacy has contracted with Professional Credential Services, Inc. (PCS), Nashville, TN, to process its applications for examination and licensure / registration of pharmacists, pharmacy interns and pharmacy technicians. These services include all activities related to the dissemination of forms and the evaluation of any applications for the above referenced candidates. Applicants for a license / registration in pharmacy must submit all of their information directly to PCS.
Professional Credential Services Contact Information
Address: 150 Fourth Avenue North, Suite 800
Nashville, TN 37219
Telephone: (877) 887-9727 - within the United States
(615) 880-4275 - outside the United States
Internet: www.pcshq.com
Personal License / Registration
- Affidavit in Support of Application for Registration/Licensure to Practice as a Pharmacist / Pharmacy Intern / Pharmacy Technician (PDF) | Word
- Criminal Offender Record Information (CORI) Request Form (if applicable) (PDF) | Word
- Disability Accommodations Form for Students (PDF) | Word
- Nuclear Pharmacist (PDF) | Word
Facilities License/Registration
- Important Fee Information regarding Facility Forms and Applications (PDF) | Word
- Change of Manager of Pharmacy or Pharmacy Department (PDF) | RTF
- Relocation of Pharmacy or Pharmacy Department (PDF) | Word
- Transfer of Ownership for Pharmacy or Pharmacy Department (PDF) | Word
- Certificate of Fitness (PDF) | Word
- Store Hours (PDF) | Word
- Controlled Substance Registration (PDF) | RTF
- New Wholesale Distributor (PDF) | Word
- Relocation of a Wholesale Distributor (PDF) | Word
- Transfer of Ownership for a Wholesale Distributor (PDF) | Word
- Discontinuance of a Community Pharmacy or Pharmacy Department (PDF) | Word
- Registration to Manage and Operate a Nuclear Pharmacy (PDF) | Word
- Relocation of a Nuclear Pharmacy (PDF) | Word
- Transfer of Ownership of a Nuclear Pharmacy (PDF) | Word
- Registration to Manage and Operate a New Community Pharmacy (PDF) | Word
- Petition to Waiver (PDF) | Word
- Self-Inspection Form for Pharmacies (PDF) | RTF
Continuing Education
Miscellaneous
- Online Change of Address
- Change of Address or Name or Duplicate License (PDF) | Word
- Duplicate License for a Business (PDF) | Word
- Wall Certificate Service (Pharmacist)
This information is provided by the Division of Health Professions Licensure within the Department of Public Health.