Thank you for choosing to pay for your service with the Board's online payment option. This form is for paying for your Application for Exam & License and initial registration to dispense drugs and/or devices.
Application for Exam & License - $450.00
Initial registration to dispense drugs and/or devices - $200.00
A $3.00 convenience fee will be added to each online transaction.
The total billed will be $653.00
Fields marked with an asterisk are required and must be completed prior to clicking Pay Now.