Request a name change, address change, or a duplicate license for pharmacist licensing

If you are a pharmacist, pharmacy technician, pharmacy intern, or pharmacy facility, you can use these steps to request a name change, address change, and/or a duplicate license.

Board of Registration in Pharmacy

The Details of Request a name change, address change, or a duplicate license for pharmacist licensing

What you need for Request a name change, address change, or a duplicate license for pharmacist licensing

If you are requesting changes online:

  • You will need your Online Licensing username and password
    • If you do not have an account yet, you may search for your records with your date of birth and SSN
  • You cannot request a name change through the online portal. This must be done via mail.

If you are requesting changes through paper application, you need your:

  • License number
  • Social Security Number
  • Date of birth

For a name change

You must return the original hard copy of your license and submit a copy of supporting documents. Supporting documents include:

  • Marriage certificate
  • Divorce decree
  • Court documents
  • Other documentation

Fees for Request a name change, address change, or a duplicate license for pharmacist licensing

For duplicate licenses:

  • You must pay the duplicate license fee for each license you wish to have duplicated

There are no fees for:

  • Address changes
  • Name changes with renewal

Pay by check or money order, payable to the Commonwealth of Massachusetts.

  • Don't send cash or electronic funds transfers.
Name Fee Unit
Duplicate license $17 per license
Name change with new license $27 per license

How to request Request a name change, address change, or a duplicate license for pharmacist licensing

  1. Download and complete the application, found below
  2. Attach all documentation and fees
  3. Mail to:

Bureau of Health Professions Licensure
239 Causeway St.
Suite 500, 5th Floor
Boston, MA 02114

Please note: name changes must be submitted via mail with applicable attachments

For requesting address changes and/or duplicate licenses, you can login to our Online Licensing portal.

More info about Request a name change, address change, or a duplicate license for pharmacist licensing

  • If you are requesting a name change and you have a current or expired license with another board within the Bureau, the requested name change will be effective for all boards
  • All addresses are subject to disclosure on request (MGL c. 4, s. 7)

Downloads for Request a name change, address change, or a duplicate license for pharmacist licensing

Contact for Request a name change, address change, or a duplicate license for pharmacist licensing

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