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.
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Pharmacy Technician Registration Number
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Previous Name
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New Name
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Effective date of the change
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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.
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Pharmacy Technician Registration Number
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Previous Address
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New Address
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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.)
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Pharmacy Technician Registration Number
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Previous Employer
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New Employer
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Effective date of the change
Mailing Address:
Department of Consumer Protection
Commission of Pharmacy
Email Address:
450 Columbus Boulevard, Suite 801
Hartford, CT 06103
Email Address: