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.

• Pharmacy Technician Registration Number
• Previous Address
• New Address
• Effective date of the change

Change of Employment:

• Pharmacy Technician Registration Number
• Previous Employer
• New Employer
• Effective date of the change

Department of Consumer Protection

• DCP.COP@ct.gov