IMPORTANT INFORMATION REGARDING YOUR CONTROLLED SUBSTANCE REGISTRATION (CSR) RENEWAL, PRESCRIBING CONTROLLED SUBSTANCES , AND ONLINE RENEWAL: 1. SSN Affidavit Form. 345 0 obj <> endobj Use this application if you are an Analytical Lab, a Teaching Institute, or a Controlled Substance Researcher. First time users, click the Self Register link and go to step 2. Showing 0 to 0 of 0 entries The maximum number of results is limited to 25. CSOS (Controlled Substances Ordering System) If you are a first time user, please see the instructions below. New Mexico Regulation & Licensing Department | Contact Us | Sitemap 2550 Cerrillos Road, Santa Fe, NM 87505 | Get Directions 5500 San . There are several situations in which an applicant may not hold a DEA or CDS certificate. In the interim, please access the license applications through the Applications and Forms page, or through the link below: Individuals with a physical or cognitive disability that requires reasonable accommodation in order to allow the individual to complete necessary forms or applications to obtain licenses or permits, or reasonable accommodations to participate in services or programs of the NMRLD, may contactHeather.Sanchez-Martinez@rld.nm.govfor assistance in reaching appropriate NMRLD staff. For procedures for initial licensure. New Mexico Regulation & Licensing Department | Contact Us | Sitemap2550 Cerrillos Road, Santa Fe, NM 87505 | Get Directions5500 San Antonio Dr., Albuquerque, NM 87109 | Get Directions505 South Main Street, Las Cruces,NM 88001 | Get Directions1209 Camino Carlos Rey, Santa Fe, NM 87507 | Get Directions, Employee Resources:Employee Email|SHARE Portal. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. Note that you may renew your license beginning seventy-five days before the license expiration date. This facility is explained inregulation part 11. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. %PDF-1.5 % For facilities that will do research with dangerous drugs. Home Care Service Applicationas defined inregulation part 19. A facility that is currently registered with the Food and Drug Administration (FDA) as an outsourcing facility under Section 503B of the Federal Food, Drug, and Cosmetic Act, and that meets the requirements of that agency to engage in the compounding and distribution of sterile drugs. A Facility Controlled Substance Application is needed if controlled substances are stored at the facility. Peace Officer Exemption Form. Note that you may renew your license beginning 75 days before the license expiration date. This process should be documented in the organizations policies and include any time frame limits on obtaining the DEA or CDS after credentialing is approved (e.g., six months). If you are unable to view the data you are looking for, please refine your search. For procedures for initial licensure,click here. Individuals with a physical or cognitive disability that requires reasonable accommodation in order to allow the individual to complete necessary forms or applications to obtain licenses or permits, or reasonable accommodations to participate in services or programs of the NMRLD, may contactHeather.Sanchez-Martinez@rld.nm.govfor assistance in reaching appropriate NMRLD staff. Request Copy of Last Application/Receipt. Registrant type (first letter of DEA Number): A/B/F/G Hospital/Clinic/Practitioner/Teaching Institution/Pharmacy, M Mid-Level Practitioner (NP/PA/OD/ET, etc. First Name Last Name Company Name DBA Name PVL Number (including license type and number, i. endstream endobj 346 0 obj <. Email: DEARegistrationIDAHO@dea.gov For more information: Drug Enforcement Administration website. REGULATIONS.GOV, DOJ Legal Policies and Disclaimers|DOJ Privacy Policy|FOIA|Section 508 Accessibility. 1308.11 through 1308.15. DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. Idaho DEA Registration Technician Contact. Defined in. Drug Supply Chain Integrity, Recalls, Market Withdrawals and Safety Alerts, FDA Leads Effort to Create a Supply Chain Security Toolkit for Medical Products, Verify Wholesale Drug Distributor Licenses, https://azbop.igovsolution.net/online/Lookups/AZBusiness_Lookup.aspx, http://www.pharmacy.ca.gov/about/verify_lic.shtml, https://www.colorado.gov/dora/licensing/Lookup/LicenseLookup.aspx, https://www.elicense.ct.gov/Lookup/LicenseLookup.aspx, https://delpros.delaware.gov/OH_VerifyLicense, https://app.hpla.doh.dc.gov/Weblookup/Search.aspx?facility=Y, https://www.myfloridalicense.com/wl11.asp?mode=2&search=LicTyp&SID=&brd=&typ=, https://gadch.mylicense.com/verification/Search.aspx?facility=Y, https://idbop.mylicense.com/verification/Search.aspx?facility=Y, https://online-dfpr.micropact.com/lookup/licenselookup.aspx, https://mylicense.in.gov/everification/Search.aspx?facility=Y, https://ibop.igovsolution.net/online/Lookups/LookUp_Business.aspx, https://ksbop.elicensesoftware.com/portal.aspx, https://secure.kentucky.gov/pharmacy/licenselookup/Default.aspx, http://www.lsbwdd.org/wholesaler-license-lookup/, http://pfr.informe.org/almsonline/almsquery/SearchCompany.aspx, https://bopgl.hlb.state.mn.us/glsuiteweb/clients/mnbopharm/public/licenseesearch.aspx, https://www.nebraska.gov/hhs/lists/search.cgi, http://web.doh.state.nj.us/apps2/FoodDrugLicense/fdSetSearch.aspx, http://verification.rld.state.nm.us/Search.aspx?facility=Y, https://apps.ncagr.gov/agrsysportal/publiclicensesearch/index?owner=FDPD, http://lv.pharmacy.ok.gov/osbpinquire/FacilitySearch.asp, https://healthri.mylicense.com/Verification/Search.aspx?facility= Y&SubmitComplaint=Y, https://verify.llronline.com/LicLookup/Pharmacy/ Pharmacy.aspx?div=24, https://apps.health.tn.gov/facilityListings/, https://www.dshs.state.tx.us/drugs/license-verification.aspx, https://secure.utah.gov/llv/search/index.html, https://secure01.virginiainteractive.org/dhp/cgi-bin/ search_publicdb.cgi, https://fortress.wa.gov/doh/facilitysearch/, https://www.wvbop.com/public/verify/index.asp, https://wybopprod.glsuite.us/GLSuiteweb/clients/wybop/public/verification/search.aspx, Alaska Department of Commerce, Community and Economic Development, Colorado Department of Regulatory Agencies, Connecticut Department of Consumer Protection, Delaware Division of Professional Regulation, District of Columbia Health Professional Licensing Administration, Florida Department of Business & Professional Regulation, Hawaii Department of Commerce & Consumer Affairs, Illinois Department of Financial and Professional Regulation, Louisiana Board of Wholesale Drug Distributors, Massachusetts Office of Health and Human Services, Michigan Department of Licensing and Regulatory Affairs, Missouri Division of Professional Regulation. Online Services. Dentist Controlled Substances. Click herefor more information about the PMP. Acceptable verification sources include a copy of the certificate, the DEA or CDS agency, the National Technical Information Service, the state CDS agency, and the American Medical Association (AMA) or American Osteopathic Association (AOA) profile. New Mexico Regulation & Licensing Department | Contact Us | Sitemap2550 Cerrillos Road, Santa Fe, NM 87505 | Get Directions5500 San Antonio Dr., Albuquerque, NM 87109 | Get Directions505 South Main Street, Las Cruces,NM 88001 | Get Directions1209 Camino Carlos Rey, Santa Fe, NM 87507 | Get Directions, Employee Resources:Employee Email|SHARE Portal. Temporarily suspends controlled substance registration requirement for practitioners ; Department of Public Health issued order reinstating requirement that the collection and analysis of a COVID-19 specimen be made by a licensed physician or other licensed person authorized by law to make diagnoses, including pharmacists ; Executive Order 7KK Effective January 1, 2021, Texas Health and Safety Code, 481.0755 requires that prescriptions for controlled substances to be issued electronically, except in limited circumstances, or unless a waiver has been granted by the appropriate agency. States that have a pharmaceutical licensing agency may use that agency for verification as well. Use this form to report facility address or namechange. Outsourcing Facility Applicationas defined inregulation 16.19.37. DEA Form 224a - Retail Pharmacy, Hospital/Clinic, Practitioner, Teaching Institution, or Mid-Level Practitioner 2023 Bamboo Health. Limited Controlled Substance Registration Application. u.s. department of justice drug enforcement administration Diversion Control Division 8701 Morrissette Drive Springfield, VA 22152 1-800-882-9539 DEA.GOV | JUSTICE.GOV | USA.GOV | REGULATIONS.GOV If the OCSA verification website shows a status of 'PENDING,' please contact the Office of Controlled Substances Administration at 410-764-2890 for more information. Our Mission To provide practitioners, pharmacists, and other authorized users the ability to review a patient&x27;s controlled substance prescription history and assist in the prevention of diversion, abuse, misuse, and drug overdose deaths associated with controlled substance prescriptions. Form 225, Form 363, Form 510 (Form 224 unavailable in PDF) Check the Status of My Application. Also, you may obtain the SBEM Class D Clinic Annual Self-Assessment form. u.s. department of justice drug enforcement administration Diversion Control Division 8701 Morrissette Drive Springfield, VA 22152 1-800-882-9539 DEA.GOV | JUSTICE.GOV | USA.GOV | REGULATIONS.GOV This form cannot be used if there is a change of ownership, or for a change of physical locationfor facilities that compound sterile preparation/product delivered into NM (new application required). ), U.S. State Agencies Responsible for Licensing Wholesale Prescription Drug Distributors, https://albop.igovsolution.net/online/Lookups/Individual_Lookup.aspx, https://www.commerce.alaska.gov/cbp/main/Search/Professional, https://mdbop.mylicense.com/Verification/Search.aspx?facility=Y, https://madph.mylicense.com/verification/Search.aspx?facility=Y, https://aca-prod.accela.com/MILARA/GeneralProperty/PropertyLookUp.aspx?isLicensee=Y&TabName=APO, https://gateway.mbp.ms.gov/Verification/search.aspx, https://pr.mo.gov/pharmacy-licensee-search.asp, https://ebizws.mt.gov/PUBLICPORTAL/searchform?mylist=licenses, https://forms.nh.gov/licenseverificationtest/Search.aspx?facility=, https://orbop.mylicense.com/verification/Search.aspx?Facility=Y, https://apps.health.pa.gov/DDC/DDCPublicLookup.asp, https://sdbop.igovsolution.net/online/Lookups/LookUp_Business.aspx, https://secure.professionals.vermont.gov/prweb/PRServletCustom/app/NGLPGuestUser_/V9csDxL3sXkkjMC_FR2HrA*/!STANDARD?UserIdentifier=LicenseLookupGuestUser, An official website of the United States government, : Prescription drugs should only be purchased from wholesale drug distributors licensed in the United States. You may download and print your own forms or contact our office and we will mail them to you. License Verification Standards (73 KB PDF) Continuing Education. Changes include a name change, change in home address, or a change in employment information. The BNDD no longer mails certificates and they may be printed from this link below. If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application. One way the Board accomplishes this is by receiving complaints and disciplining licensees and certificate holders who violate the law and rules. Defined inregulation part 22. For all facilities except for Methadone Clinics and facilities licensed as Analytical Labs, Teaching Institutes, or Controlled Substance Researchers. DEA Controlled Substance Registration Applications this is a link to the DEA website for DEA controlled substance registration applications. Then you can log in and renew your license. Name and Address Change Form. hbbd```b``+@$M,R E6@$Xl"&E>HY0DrGeA$C(d+Ad_j_L/GI,F DL for clinics that are defined as a public health clinic in. This manual does not supply the forms. Phone: 1-571-387-2800. Please select the type of license you wish to search for. Verify your professional is licensed before using their services. CMEA (Combat Meth Epidemic Act) Under the Illinois Controlled Substances Act narcotic and non-narcotic schedules are combined and the &x27;N&x27; designation is not needed. These clinics are licensed as A, B1, B2, B3, C, or E. For procedure for initial licensure,click here. Promote, preserve and protect the health, safety, and welfare of the public by and through the effective control and regulation of the practice of pharmacy. 221 0 obj <> endobj Learn more about each of the unique professional occupations, visit the division, board, and program section you are interested in. . The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. The DEA will verify temporary licenses with assigned delegation for registration of a DEA CSR directly with board staff. Graduate permit may be requested if needed