Notification of Disassociation of PIC/DRIC/RMG
Clear your web browsers cache to ensure you are completing the current applications. Ctrl + F5 is used to force reload a webpage on Windows computers. On Macs, Option + Command + E is the keyboard shortcut to force reload. Failure to complete the current application versions may result in additional deficiencies related to your application.
A licensee is required to notify the Board when ceasing to act as a pharmacist–in–charge (PIC), designated representative–in–charge (DRIC) or responsible manager (RMG). Below are disassociation forms available as a convenience and is intended to assist licensees in providing the required notification to the Board. No fee is required for the notification of disassociation. Completed forms may be submitted to the Board via mail or e–mail by using the email address provided on the form. Additionally, you may submit a contact form to the Board, regarding the details of your disassociation.
- Pursuant to BPC 4101(a), any pharmacist–in–charge who ceases to act as the pharmacist–in–charge of any pharmacy shall notify the Board in writing within 30 days of the date of that change in status.
Notification of PIC Disassociation (17A–121) – (PDF) - Pursuant to BPC 4101(b), any designated representative–in–charge who ceases to act as the designated representative–in–charge at any wholesaler or veterinary food–animal drug retailer shall notify the Board in writing within 30 days of the date of that change in status.
Notification of DRIC Disassociation (17A–122) – (PDF) - Pursuant to BPC 4101(c), any responsible manager who ceases to act as the responsible manager at any third–party logistics provider shall notify the Board in writing within 30 days of the date of that change in status.
Notification of RMG Disassociation (17A–123) – (PDF)
Send the disassociation notification via mail, fax or send us a message.
Change Notification
Review the instructions on the appropriate change notification form for the required fee and any additional requirements when submitting the change notification. An updated facility license will be issued upon approval and completion of the notification.
Change of Pharmacist–in–Charge (PIC)
- California: A pharmacy located in California is required to notify the Board within 30 days of the date when a PIC ceases to act as the PIC, and shall on the same form propose another pharmacist to take over as the PIC. (Bus. & Prof. Code § 4113.)
- Nonresident: Effective July 1, 2026, a nonresident pharmacy must identify a California–licensed pharmacist employed and working at the nonresident pharmacy to be proposed to serve as PIC over the nonresident pharmacy's California operations. A nonresident pharmacy is required to notify the Board within 90 days of the date when a PIC ceases to act as the PIC, and shall on the same form propose another PIC to take over as the PIC. (Bus. & Prof. Code § 4113.)
- Apply for the pharmacist examination for licensure in California.
Proposed PIC: The proposed replacement PIC shall be subject to approval by the Board. If disapproved, the pharmacy shall propose another replacement within 15 days of the date of disapproval and shall continue to name proposed replacements until a PIC is approved by the Board. Failure to make this required notification to the Board may result in a citation and fine or disciplinary action. (Bus. & Prof. Code § 4113(e).)
Interim PIC: If a pharmacy is unable, in the exercise of reasonable diligence, to identify within 30 days a permanent replacement pharmacist–in–charge to propose to the Board on the notification form, the pharmacy may instead provide on that form the name of any pharmacist who is an employee, officer, or administrator of the pharmacy or the entity that owns the pharmacy and who is actively involved in the management of the pharmacy on a daily basis, to act as the interim pharmacist–in–charge for a period not to exceed 120 days. The pharmacy, or the entity that owns the pharmacy, shall be prepared during normal business hours to provide a representative of the Board with the name of the interim pharmacist–in–charge with documentation of the active involvement of the interim pharmacist–in–charge in the daily management of the pharmacy, and with documentation of the pharmacy's good faith efforts prior to naming the interim pharmacist–in–charge to obtain a permanent pharmacist–in–charge. By no later than 120 days following the identification of the interim pharmacist–in–charge, the pharmacy shall propose to the Board the name of a pharmacist to serve as the permanent pharmacist–in–charge. The proposed permanent pharmacist–in–charge shall be subject to approval by the Board. If disapproved, the pharmacy shall propose another replacement within 15 days of the date of disapproval, and shall continue to name proposed replacements until a pharmacist–in–charge is approved by the Board. (Bus. & Prof. Code § 4113(f).)
PIC Responsibilities: The PIC of a pharmacy shall be employed at that location and shall have responsibility for the daily operation of the pharmacy. The proposed PIC is required to complete the Board's Pharmacist–in–Charge Overview and Responsibility training course, within two years prior to the date of application to serve as a PIC. (Cal. Code of Regs, tit. 16, § 1709.1).
Change of Pharmacist–in–Charge Application
Change of Responsible Manager (RMG)
Business and Professions Code Sections 4160(g), states, “A third–party logistics provider shall notify the board in writing, on a form designed by the board, within 30 days of the date when a responsible manager ceases to act as the responsible manager, and shall on the same form propose another designated representative–3PL to take over as the responsible and shall on the same form propose another designated representative–3PL to take over as responsible manager. The proposed replacement responsible manager shall be subject to approval by the board. If disapproved the third–party logistics provider shall propose another replacement within 15 days of the date of disapproval, and shall continue to name proposed replacements until a responsible manager is approved by the board.”
The responsible manager is responsible for ensuring compliance of the licensed place of business with state and federal laws with respect to dangerous drugs and dangerous devices received by, stored in, or shipped from the licensed place of business of the third–party logistics provider.
Change of Responsible Manager Application
Change of Professional Director in a Licensed Clinic
Business and Professions Code section 4182 and 4192, states, “Licensed clinics shall notify the board within 30 days of any change in professional director on a form furnished by the board. The professional director is responsible for the safe, orderly, and lawful provision of pharmacy services. To notify the Board of a change of professional director, a Clinic Change of Permit Application is required to be submitted along with the fee.
Change of Professional Director