Source: https://azbop.igovsolution.com/online/pharmacist_app/full_exam.aspx
Timestamp: 2019-04-25 18:11:45+00:00

Document:
Full Exam applicants will be taking both the Naplex exam and the Arizona MPJE exam for Arizona. It is not necessary to take these exams in Arizona.
You must be a recent graduate of an accredited US university Pharmacist degree program.
If you are a graduate of a foreign university, you must submit a copy of your FPGEC certificate. You must also have earned 1500 intern hours in the US.
You must also be a US citizen or a legal resident with permission to work in the United States and must meet all current US immigration policies. If you are here on a student F-1 visa or H-1B visa, please contact the Licensing Coordinator before submitting your application.
*Please do not apply more than 30 days prior to your graduation date, as your application will not be accepted.
*Please be sure to read the Application Requirements below and select the correct application type as application fees are not refundable.
I have read and understand the application requirements.
Check if mailing address is the same as above.
Title IV of the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (the "Act"), 8 U.S.C. § 1621, provides that, with certain exceptions, only United States citizens, United States non-citizen nationals, non-exempt "qualified aliens" (and sometimes only particular categories of qualified aliens), nonimmigrants, and certain aliens paroled into the United States are eligible to receive state, or local public benefits. With certain exceptions, a professional license and commercial license issued by a State agency is a State public benefit.
Arizona Revised Statutes § 41-1080 requires, in general, that a person applying for a license must submit documentation to the license agency that satisfactorily demonstrates the applicant’s presence in the United States is authorized under federal law. Please see the Board's website for the list of acceptable documentation.
Are you a citizen or national of the United States?
To be completed by applicants who are not citizens or nationals of the United States. Please indicate alien status by checking the appropriate box. Attach a legible copy of a document from the technician Instructions (proof of legal residency) or other document as evidence of your status.
1. An alien lawfully admitted for permanent residence under the Immigration and Nationality Act (INA).
2. An alien who is granted asylum under Section 208 of the INA.
3. A refugee admitted to the United States under Section 207 of the INA.
4. An alien paroled into the United States for at least one year under Section 212(d)(5) of the INA.
5. An alien whose deportation is being withheld under Section 243(h) of the INA.
6. An alien granted conditional entry under Section 203(a)(7) of the INA as in effect prior to April 1, 1980.
7. An alien who is a Cuban/Haitian entrant.
8. An alien who has, or whose child or child's parent is a battered alien or an alien subject to extreme cruelty in the United States.
9. A nonimmigrant under the Immigration and Nationality Act [8 U.S.C § 1101 et seq.] Nonimmigrants are persons who have temporary status for a specific purpose. See 8 U.S.C § 1101(a)(15).
13. A foreign national not physically present in the United States.
14. A person not described in categories 1-13 who is otherwise lawfully present in the United States. PLEASE NOTE: The federal Personal Responsibility and Work Opportunity Reconciliation Act may make persons who fall into this category ineligible for licensure. See 8 U.S.C. § 1621(a).
Do you have a current AZ Intern License?
Has any formal disciplinary action, including but not limited to, censure, fine, suspension, probation, restriction of practice or revocation, ever been taken against your license or other professional certificate? If yes, provide full details, which must include the nature and date of each action and the state or jurisdiction involved. You must also provide a copy of the Order relating to the disciplinary action.
Do you have any disciplinary actions, sanctions or investigations pending against a professional license or certificate? If yes, provide full details.
Have you ever been refused or denied a license or certificate or renewal thereof to practice as a pharmacy professional or any other profession in any state, territory, district or country? If yes, provide full details, which must include the type and date of application and the state or jurisdiction involved. You must also provide a copy of the Order or letter of denial.
Have you ever been arrested for, charged with, pled guilty or no contest to, or been convicted of a felony or misdemeanor offense? (You must answer “yes” even if an arrest or conviction has been pardoned, expunged, set aside, dismissed or your civil rights have been restored.) If yes, provide full details, which must include the date, court, case number, state of prosecution and nature of the charge(s). You must also provide court documentation related to the case(s).
Confidential question -- Do you currently use or are you addicted to alcohol or a controlled substance, prescription-only drug, or dangerous drug or narcotic to such an extent that your ability to safely practice as a pharmacy professional is impaired? If yes, please provide a detailed description of your use or addiction, including treatment received (dates, names of programs, names of treating physicians).
Confidential question -- Do you currently suffer from a physical, mental, emotional, or nervous disorder or condition that impairs your ability to practice safely as a pharmacy professional? If yes, please provide additional information, including a detailed description of the disorder or condition and the name and contact information for all current treatment providers and for all monitoring or support programs in which you are currently participating.
I state and depose that all facts, statements and answers provided in this application and its attachments are true and correct; I am not omitting any information that may be of value to this Board in determining my qualifications; and I agree that any falsification, omission, or withholding of information of facts concerning my qualifications as an applicant shall be sufficient grounds upon which to deny my application for licensure and shall serve as sufficient grounds for the revocation, cancellation, or suspension of my license in pharmacy if it is not discovered until after issuance. A.R.S. § 32-1267.
An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.
This section may be enforced in a private civil action and relief may be awarded against the state. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the state for a violation of this section.
A state employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the Agency's adopted personnel policy.
This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.
Please note that after you click the Submit button, you cannot make changes to your application.

References: § 1621
 § 41
 § 1101
 § 1101
 § 1621
 § 32