California Pharmacist and Intern Pharmacist Licensure Application

Intern Pharmacist License All incoming students are required to obtain an Intern Pharmacist License approved by the California State Board of Pharmacy. The Office of Enrollment and Student Affairs will guide incoming students through the process. Review all documents thoroughly, including the application and supporting documents. For more information see the California State Board of Pharmacy website:

  • Read all application materials before beginning
  • Remember, your Name of Record should be EXACTLY THE SAME on all materials
  • Double check the application is filled out completely, with wet signature (original signature – not an e-signature)
  • Do not fold or staple your application (use a paper or binder clip)
  • Use N/A for sections that do not apply to you
  • Attach passport photo to front page (no need to include extra/second photo)
  • Verification of License in another state
    • If you have not previously held an intern or tech license outside of CA you can skip this section (no need to send the blank form)
    • If you have been licensed outside of CA, use the form provided or contact the board of pharmacy for the state, and request their verification process
  • Self-query – must be sealed when submitted
    • It can take up to two weeks to receive
    • Remind family, roommates, partners not to open it. If opened, you must reorder.
    • When requesting the self-query, select pharmacy intern
  • Live Scan or Fingerprints
    • If you live in CA complete a Live Scan; if you’re out of state or have not yet moved to CA, complete the Fingerprint portion
      • Please Note, ordering the fingerprint cards may take a few weeks to receive
  • When you mail it to Dr. Ault, use a tracking number. This is recommended, but not required.
  • Attention International Students:
    • You will need an ITIN or SSN prior to submitting your intern application
    • If you are an International Student and need an ITIN – please notify Dr. Ault and use these resources to apply for your ITIN
    • If you already have an SSN, use that on your application

Pharmacist Intern Licensure Application Checklist

Read ALL application instructions before completing the


  • Printed Application (pages 1 – 5, printed single-sided)
  • Intern Pharmacist Education Affidavit (page 6 – this will be completed for you and included with your application)
  • 2” x 2” Passport Picture (attached to front page of application)
  • Sealed Self-Query Report
  • Copy of Completed Live Scan (form included with application pdf)
  • If you’re outside of California, follow instructions for fingerprinting
  • Check or money order for application for $230, payable to:
  • The California State Board of Pharmacy

Include if Applicable:

  • Letter of Explanation and/or Copies of Identifications
  • Verification of License in Another State

Request an Extension of your Intern Pharmacist License

Students who take a leave of absence or delay their PharmD program due to a dual degree or another reason, may need to apply for an extension to their intern license. If you feel you may need an extension, please contact the Student Affairs office:

For assistance, email Vanessa Ault at