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Pharmacist License Change of Information

In accordance with Sections 20-576-10 and 20-576-11 of the Regulations of Connecticut State Agencies, you must notify the Commission of Pharmacy in writing, within five days, of any changes(s) of name, address or employment.

Name Change:

To complete a name change, please send an email to DCP.PharmacistLicense@ct.gov with the following information. Or, complete the Pharmacist Change Form provided on this page and mail it to the address at the bottom of the page, or fax to: (860) 706-1229.

    • Pharmacist License 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:
To complete a change of address, please send an email to DCP.PharmacistLicense@ct.gov with the following information. Or, complete the Pharmacist Change Form provided below and mail it to the address at the bottom of the page, or fax to: (860) 706-1229.
    • Pharmacist License Number
    • Previous Address
    • New Address
    • Effective date of the change

Change of Employment:

To complete a change of employment, please send an email to DCP.PharmacistLicense@ct.gov with the following information. Or, complete the Pharmacist Change Form provided on this page and mail it to the address at the bottom of the page, or fax to: (860) 706-1229.  (Please note that if you are a pharmacy manager at the new location you will need to submit a Pharmacy Manager application also.)

    • Pharmacist License Number
    • Previous Employer
    • New Employer
    • Effective date of the change
Mailing Address:

Department of Consumer Protection

Commission of Pharmacy 
450 Columbus Boulevard, Suite 801
Hartford, CT 06103

Pharmacist Change Form:
Email Address: