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Criminal History - Petition for Determination of Eligibility

An individual who has not yet submitted a completed a registration application may petition the Board for a determination of whether one or more of the individual’s convictions are disqualifying offenses that would render the individual ineligible for registration.

An individual with a conviction is not required to petition the Board for an eligibility determination prior to applying for a registration.

To petition the Board for an eligibility determination of whether one or more of the petitioner’s convictions are disqualifying offenses, a petitioner must submit all of the following:

  • A completed petition for eligibility determination form;
  • The complete criminal record for each of the petitioner’s convictions;
  • A personal statement regarding whether each conviction directly relates to the duties and responsibilities of the practice of pharmacy and why the Board should find the petitioner rehabilitated;
  • All evidence of rehabilitation that the petitioner wishes to be considered by the Board; and
  • A nonrefundable fee of $25.

The cutoff for inclusion on the Board's agenda is two weeks prior to a scheduled Board meeting. Requests received after the cutoff will be held for the following Board meeting (i.e. deadline for March 12 meeting is February 27; a request received on February 28 would not go before the Board until the next meeting).

For more information, please see 657 IAC 31.