Notice Regarding License Verification Requests (PDF)
Effective March 1, 2019, the Office of Professional and Occupational Regulation (OPOR) will no longer issue paper license verifications. License verifications are available, free of charge, on OPOR’s official database, https://www.pfr.maine.gov/ALMSOnline/ALMSQuery/Welcome.aspx?board=4380. This database is updated in real time as changes occur. The Office of Professional and Occupational Regulation considers this information to be a secure, primary source for license verification.
Applications & Forms
Individual Pharmacist Applications
- Pharmacist by Score Transfer (PDF)
- Pharmacist Reciprocity/Endorsement (PDF)
- Certificate of Administration of Drugs and Immunizations (PDF)
- Collaborative Drug Therapy Management (PDF)
- PIC change (PDF) (for currently licensed Maine pharmacies)
- Reinstatement Pharmacist (PDF)
- Reinstatement of Certification of Administration of Drugs and Vaccines (PDF)
Pharmacy Intern Applications
- Pharmacy Intern (PDF) (Educated in the U.S. or Canada)
- Pharmacy Intern (PDF) (Educated in a Foreign country other than Canada)
- Registration for Authorization to Administer Immunizations (PDF) (An active Pharmacy Intern license is required to register)
Pharmacy Technician Applications
- Pharmacy Technician (PDF)
- Pharmacy Technician (PDF) - Applicable only to the following persons employed by an Opioid Treatment Program and who holds a valid license issued by the State Board of Nursing; Advanced practice registered nurse, Registered professional nurse and Licensed practical nurse
- Registration for Authorization to Administer Immunizations (PDF) (An Active Pharmacy Technician license is required to register)
Business Applications
- Mail Order Contact Lens Supplier (PDF)
- Mail Order Prescription Pharmacy (PDF)
- Mail Order PIC change (PDF) (for currently licensed Out of State Mail Order Pharmacies)
- Manufacturer (PDF)
- Opioid Treatment Program (PDF)
- Pharmacy (PDF) (located in the State of Maine)
- Pharmacy PIC change (PDF) (for currently licensed Maine pharmacies)
- Retail Supplier of Medical Oxygen and Oxygen Devices (PDF)
- Rural Health Center (PDF)
- VAWD Accredited Wholesaler (PDF)
- Wholesaler (PDF) (Not VAWD Accredited)
- Reporting Jurisdictions of Licensure (PDF)
General Reporting Forms
Other Forms
- Continuing Education (PDF)
- Replacement License Request Form (PDF)
- Verification request form to send to other states (PDF)
- Pharmacy Inspection Form - General (PDF)
- Pharmacy Inspection Form - Opioid Treatment Program / Center and Automated Dispensing (PDF)
- Pharmacy Inspection Form - Rural Health Centers (Pharmacy Services) (PDF)
- Credit Card Authorization Form (PDF) - To authorize payment of fees by Visa, MasterCard, American Express or Discover.