Pharmacy Technician Change of Information
In accordance with Section 20-576-11 of the Regulations of Connecticut State Agencies, you must notify the Commission of Pharmacy, in writing, within five days, of any change(s) of name or home address.
Name Change:
To complete a name change, please send an email to DCP.COP@ct.gov with the following information or complete the form below and mail it to the address at the bottom of the page or fax it to (860) 706-1229.
-
Pharmacy Technician Registration Number
-
Previous Name
-
New Name
-
Effective date of the change
-
Please include any supporting documentation i.e. marriage license, copy of a driver's license, official court documents etc.
Address Change:
-
Pharmacy Technician Registration Number
-
Previous Address
-
New Address
-
Effective date of the change
Change of Employment:
-
Pharmacy Technician Registration Number
-
Previous Employer
-
New Employer
-
Effective date of the change
Department of Consumer Protection
Email Address: