Connecticut State Department of Consumer Protection

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:
To complete a change of address, 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 Address
    • New Address
    • Effective date of the change

Change of Employment:

To complete a change of employment, 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. (Please note that if you are a pharmacy manager at the new location you will need to submit a Pharmacy Manager application also.)
    • Pharmacy Technician Registration 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

Email Address: