South Dakota Board of Pharmacy

Pharmacist Initial / New Application

NEW PHARMACIST INSTRUCTIONS

For application information and instructions, please go to this link: https://doh.sd.gov/licensing-and-records/boards/pharmacy/licensing-requirements/pharmacists/

TYPE OF APPLICATION

IMPORTANT: Both the NABP application for license transfer (e-LTP) and this application MUST be completed prior to reciprocal licensure in South Dakota. NABP Licensure transfer link: https://nabp.pharmacy/programs/licensure-transfer/
1,500 internship hours in a licensed pharmacy or other board-approved location has been completed and reported to the SD Board of Pharmacy.
Are you currently a deployed active duty military member?

Are you currently a spouse of a deployed active duty military member?

PHARMACIST INFORMATION

EDUCATION

PRACTICAL EXPERIENCE COMPLETED

College Based Clinical Program
Are these intern practical experience hours?

AUTHORIZATION TO ADMINISTER IMMUNIZATIONS

Will you be administering immunizations?

This certificate is the 20-hour immunization delivery course (NOT continuing education)

RECORD OF DISCIPLINE, CHARGES AND CONVICTIONS

1. Have you ever been convicted, pled guilty or no contest, or received a suspended imposition of sentence for a felony or other criminal offense (excluding minor traffic violations)?

2. Is there any pending criminal prosecution against you other than minor traffic violations?

3. Has your license to practice pharmacy in any jurisdiction been denied, revoked, suspended, stipulated, placed on probation, or otherwise subjected to any type of disciplinary action?

4. Are you currently being investigated or the subject of pending disciplinary action?

5. Have you ever received treatment for abuse or misuse of alcohol and/or chemical substance to the extent that your ability to practice pharmacy was impaired?

6. Have you ever experienced a physical, emotional, and/or mental condition that endangered the health or safety of persons entrusted in your care?

7. Do you have child support arrearages in the sum of one thousand dollars or more?

8. Will you follow the Rules of Professional Conduct as outlined in ARSD 20:51:16?

Attachments

APPLICATION INPUT PREVIEW

AFFIRM AND SUBMIT

All application fees are nonrefundable and nontransferable.

  
College Based Clinical Program
Are these intern practical experience hours?
  
Please note that after you click the Submit button, you cannot make changes to your application.

Mailing Address: 4001 W Valhalla Blvd, Sioux Falls, SD 57106 Phone: (605) 362-2737

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