Ariz. Admin. Code § 4-18-903

Current through Register Vol. 30, No. 50, December 13, 2024

Section R4-18-903 - Application for a Certificate to Dispense; Renewal

A. An applicant for a certificate to dispense shall submit:

1. An application to the Board that contains:

a. The applicant's:

i. Full legal name;

ii. Naturopathic license number, if known; and

iii. Social Security number;

b. If a corporation, a statement of whether the corporation holds tax exempt status;

c. A statement of whether the applicant holds a drug enforcement number issued by the United States Drug Enforcement Administration, and if so, the drug enforcement number;

d. A statement of whether the applicant has ever had the authority to prescribe, dispense, or administer a natural substance, drug, or device limited, restricted, modified, denied, surrendered or revoked by a federal or state agency or court of law, and if so, an explanation that includes:

i. The name and address of the federal or state agency or court having jurisdiction over the matter, and

ii. The disposition of the matter;

e. A statement, signed by the applicant, that the applicant agrees to conform to all federal and state statutes, regulations, and rules; and

f. The date the application is submitted; and

2. Unless exempted by A.R.S. § 32-1530, the fee required by the Board.

B. A certificate holder shall renew a certificate to dispense on or before July 1 of each year by submitting:

1. An application to the Board that contains:

a. The applicant's full legal name;

b. If a corporation, a statement of whether the corporation holds tax exempt status;

c. A statement of whether the applicant has had the authority to prescribe, dispense, or administer a natural substance, drug, device limited, restricted, modified, denied, surrendered or revoked by a federal or state agency or court of law, during the one year period immediately preceding the renewal date and if so, an explanation that includes:

i. The name and address of the federal or state agency or court having jurisdiction over the matter; and

ii. The disposition of the matter; and

d. A statement, signed and dated by the applicant, verifying the information on the application is true and correct and the applicant is the licensee named on the application; and

2. Unless exempted by A.R.S. § 32-1530, the fee required by the Board.

C. The Board shall grant or deny the certificate to dispense or renewal of certificate to dispense according to the time-frames in 4 A.A.C. 18, Article 7, Table 1.

Ariz. Admin. Code § R4-18-903

New Section made by final rulemaking at 19 A.A.R. 1302, effective July 6, 2013 (Supp. 13-2). Amended by final rulemaking at 30 A.A.R. 348, effective 4/1/2024.