TEXAS STATE BOARD OF PHARMACY
333 Guadalupe Street, Ste. 3-600 |
Austin, Texas 78701 |
512-305-8021 |
512-305-8082 (fax) |
www.tsbp.state.tx.us |
NEW PHARMACY CHECKLIST
(Submit this form only after all the items on this checklist are complete)
PHARMACY NAME & LOCATION ADDRESS (Street, City, ZIP)
A building with space adequate for the size and scope of pharmaceutical services provided by the pharmacy.
An area dedicated for the prescription department, including an area suitable for confidential patient counseling if the pharmacy serves the general public.
Water supply exists.
Electrical supply exists
Fixtures (i.e. shelving, counter tops, etc.) for storage of drugs, equipment and supplies, necessary to operate a pharmacy have been ordered.
Does the prospective owner currently have ownership interest in any other pharmacy in Texas?
If yes, please provide the name and address of the pharmacy:
THIS FORM MUST BE SUBMITTED WITH ALL
NEW PHARMACY APPLICATIONS
LIC-018 (Rev. 08/04) |
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