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Name Change Form

The name of a current Louisiana licensee for distribution of legend drugs and legend devices may be changed if the name change is NOT the result of any changes in ownership. Changes in ownership of a licensee company/facility require submission of an application for new licensure as licenses are NOT transferable with regards to ownership changes.

  1. HAVE ALL REQUIRED DOCUMENTATION READY for upload, such as incorporation amendment or corporate resolution indicating the name change and the effective date for the name change, and (for out-of-state licensees) a copy of the home state license in the name.
  2. HAVE PAYMENT TOOLS AVAILABLE and ready, such as credit card or bank account information for e-check payments; processing charge of $25.
  3. ENTER THE LOUISIANA LICENSE NUMBER below for the name change. PLEASE CHECK NAME OF THE LICENSEE that is provided on the form
    that comes up to verify the correct Louisiana license number was provided.
  4. COMPLETE the name change request form.
  5. PRINT a copy of the completed name change form for your records BEFORE submitting the form.
License Number:


Verification Form

  1. HAVE ALL REQUIRED DOCUMENTATION READY for upload.
    1. If the state requiring the license verification has a standard license verification form, complete portion of form for licensee and sign if applicable; then scan for upload submission.
  2. HAVE PAYMENT TOOLS AVAILABLE and ready, such as credit card or bank account information for e-check payments; $15 license verification fee required.
  3. ENTER THE LOUISIANA LICENSE NUMBER below for the verification. PLEASE CHECK NAME OF THE LICENSEE that is provided on the form
    that comes up to verify the correct Louisiana license number was provided.
  4. COMPLETE thelicense verification request form.
  5. PRINT a copy of the completed license verification change form for your records BEFORE submitting the form.
License Number:


License Change Form

Changes of information for a current Louisiana drug/device distributor license, such as changes to the facility and regulatory contact personnel, designated responsible party (DRP), revised lists of officers/directors or other states where licensure held, a copy of current valid home state license, or mailing address, should be submitted within 60 days after such changes become effective, per Board regulation./

NOTE: Changes to physical distribution address or business address (when a 3PLP is used for physical distribution and does not change) cannot BE CHANGED WITH THIS FORM. Louisiana licenses are NOT transferable with regards to location changes; applications for new licensure for the new distribution location are required.

1. PLEASE HAVE ALL REQUIRED DOCUMENTS READY for upload, when applicable, such as the completed DRP qualifications review form (for change of DRP), revised officers/directors list, new list of other states where licensure is held, and/or copy of current valid home state license (out-of-state licenses).
Designated Responsible Party Qualification Review Form
Note: Change of DRP for licensees physically located in Louisiana ONLY requires criminal history records (background) check, Criminal history records check documents must be submitted to the Board office via USPS/carrier including: Board Authorization form, LA State Police Disclosure form, Fingerprint Card (obtained from local law enforcement agency), and fee payment of $39.25 payable to LA Dept. of Public Safety.
2. ENTER below the Louisiana license number for the change in license information request. PLEASE CHECK THE LICENSE NAME provided on the form that comes up to verify the correct Louisiana license number was provided.
3. COMPLETE the information change request form.
4. PRINT a copy of the completed information form for your records BEFORE submitting the form.

License Number:


Online License Renewal Test

Annual License Renewal Period Starts October 1st and ends December 31st annually.
Please contact our office for late renewal information.

Phone Number:
225-295-8567

Fax Number:
225-295-8568

For the 2017 renewal season, the renewal period will begin October 5th, 2016

 

Renewal Pending

It appears there is already a pending renewal request for that license number.

Please go back and check that all the information entered was correct.

If license number is correct, thank you for your patience. We will be in touch shortly regarding your pending renewal request.

Renewal Cancelled

It appears that you have cancelled your payment request.

We cannot process your license renewal without the required fees.

If you need assistance, please contact us at: 225-295-8567

Renewal Received

Thank you for you renewal application and payment!

We appreciate your patronage.

Someone from our office will be in touch shortly to confirm your license renewal.

LA Licensee Search

The Louisiana Board of Drug and Device Distributors certifies that it maintains the information for the credential verification function of this website and performs routine updates to the website. Therefore, the website is a secure and primary source for credential verification, as authentic as a direct inquiry to the Board.

Search for a Licensee

Request for License Verification:

Requests for verification of Louisiana license must be made in writing by providing the verification form provided by the state requesting the verification, providing the contact name and mailing address to return the completed verification to, and submission of the license verification fee or $15 (per LAC 46:XXXIV.801.A.6) for each verification requested.

To submit a request for license verification electronically with electronic fee payment by credit card or echeck click the below link. Please have the verification form ready to upload as well as your payment method available.

Click Here

Online License Renewal

Annual License Renewal Period Starts October 1st and ends December 31st annually. Please know that late fees are added for any renewals processed outside of these dates.

  1. Please have your payment – credit card or echeck information – available before starting the online renewal process. Payment must be made at the time of online renewal submission.
  2. In order to submit your renewal online, provide the License number and PIN as it appears on your renewal form.
  3. Complete the online renewal form.
  4. PRINT a copy of the completed renewal form for your file BEFORE submitting and entering the electronic payment processor.
License Number:

PIN (Case Sensitive):

If the pre-printed renewal form is not received by October 20, please contact the Board office by email to request a duplicate renewal form:

  • Address: admin@drugboard.la.gov
  • Subject: Request A Duplicate Renewal Form
  • Email message: Give the licensee name and LA license number.

Document will be provided by return email to requester.