Limited Distributor License

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Limited Distributors Instructions

Iowa Regulations

Required Documents

Additional Documents


License Sub-Type Identification

Business Information

Physical Address

Mailing Address

Limited Distributor Contact Information

Ownership Information

Business Practices-Select all that Apply

Products Distributed-Select all that Apply

Type of Customers-Select all that Apply

Hours of Operation

Registered Agent

Controlled Substances

Controlled Substances Handled

Federal Drug Enforcement Administration (DEA)



Food and Drug Administration (FDA)

Food and Drug Administration (FDA)

Food and Drug Administration (FDA)


Other State Licenses

Other State Licenses

Facility Manager

Facility Manager Attestation

Criminal History

Disciplinary Actions

License Denials

Pending Investigations


Confirm and Submit


Physical and Mailing Address: 6200 Park Avenue, Suite 100, Des Moines, IA 50321-1270. (P): (515) 281-5944 (F): (515) 281-4609