Thank you for choosing to pay for your service with the Board's online payment option. This form is for paying for your initial issuance of a license or dispensing registration. If you would like to make a different payment, please choose the appropriate option on the right.
License issuance - $225.00
Initial registration to dispense drugs and/or devices - $200.00
License issuance and registration to dispense drugs and/or devices - $425.00
A $3.00 convenience fee will be added to each online transaction.
Fields marked with an asterisk are required and must be completed prior to clicking Pay Now.