Initial License Issuance or Dispensing Registration

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.

Fee Information

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.