Technician Application

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Waiver of Fee -- Determination of Eligibility

Certified Pharmacy Technician (CPhT) Registration

Iowa Regulations

Disclosure of Medical Conditions, Criminal History, and Disciplinary Action


Medical Condition

Required Documents

Military or Veteran Status

Prior Iowa Board of Pharmacy Licensure or Registration

Personal Information

Home/Permanent Address

Alternate Mailing Address (optional)

Contact Information

Current Employment

Other State Licenses or Registrations

National Pharmacy Technician Certification

Criminal History

Disciplinary Actions/History

Professional License/Registration Denials

Pending Investigations

Required Documents


Confirm and Submit


Physical and Mailing Address: 400 S.W. Eighth Street, Suite E, Des Moines, IA 50309-4688. (P): (515) 281-5944 (F): (515) 281-4609