Individuals who are licensed with MDBOP may go to our online eGov site to change their address.   This can be done by logging into the site and selecting "Demographics Update."  If you do not have an eGov login, you can click on "Register a Person" on the navigation bar on the left side of the screen. You may also use the Change of Information form located below.

Name changes, employer changes, duplicate license/permit/registration requests, and verification requests must be submittted to the Board via the forms located below.

Right-Click on the blue links below and select "Save Target as.." to download the documents, then print or save and attach them to an e-mail to the Board via our Support Portal at: https://marylandboardofpharma.desk.com/.

 

 

​FORM

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ADOBE PDF
CHANGE OF INFORMATION FORM​ LINK
DUPLICATE LICENSE, PERMIT, REGISTRATION REQUEST FORM LINK
LICENSE, PERMIT, REGISTRATION VERIFICATION REQUEST FORM ​​LINK