1. A. The Board shall issue a certificate of special qualification that allows a licensee to prescribe, administer, and dispense topical diagnostic and therapeutic pharmaceutical agents or only topical diagnostic pharmaceutical agents if the licensee:

   1. 1. Was licensed by the Board before July 1, 2000;
   2. 2. Held a comparable certificate of special qualification issued by the Board before July 1, 2000; and
   3. 3. Pays the fee prescribed at A.R.S. § 32-1727.

2. B. The Board shall issue a certificate of special qualification that indicates a licensee shall not prescribe, administer, or dispense a pharmaceutical agent if the licensee:

   1. 1. Was licensed by the Board before July 1, 2000,
   2. 2. Did not hold a certificate of special qualification issued by the Board before July 1, 2000, and
   3. 3. Pays the fee prescribed at A.R.S. § 32-1727.

3. C. A licensee who holds a certificate of special qualification issued under subsection (A) or (B) may apply to the Board for a pharmaceutical agent number that indicates the licensee is authorized to prescribe, administer, or dispense topical diagnostic, topical therapeutic, and oral pharmaceutical agents. To apply for a pharmaceutical agent number, a licensee who holds a certificate of special qualification issued under subsection (A) or (B) shall:

   1. 1. Submit to the Board an application, using a form that is available from the Board, and provide the following information:

      1. a. Name of licensee;
      2. b. Social Security number;
      3. c. Mailing address;
      4. d. Telephone and fax numbers at the address listed under subsection (C)(1)(c);
      5. e. License number;
      6. f. Number of certificate of special qualification for diagnostic pharmaceutical agents, if any;
      7. g. Number of certificate of special qualification for therapeutic pharmaceutical agents, if any;
      8. h. Residential address;
      9. i. Telephone number at the address listed under subsection (C)(1)(h);
      10. j. Name of the course of study approved under R4-21-207 that the licensee completed and date of completion; and
      11. k. Applicant's dated signature affirming that the information provided is true and correct; and
   2. 2. Have a representative of the educational institution at which the licensee completed the approved course of study submit to the Board evidence that the course of study is approved and the licensee completed all course requirements; and
   3. 3. Submit written documentation that the licensee is currently certified in CPR.
4. D. The Board shall issue a pharmaceutical agent number that indicates a licensee is authorized to prescribe, administer, or dispense topical diagnostic, topical therapeutic, and oral pharmaceutical agents if the licensee is initially licensed by the Board under R4-21-201 or R4-21-202 after June 30, 2000.

Historical Note

Adopted effective February 7, 1986 (Supp. 86-1). Amended effective April 1, 1991 (Supp. 91-2). Section R4-21-208 renumbered to R4-21-209; new Section R4-21-208 renumbered from R4-21-207 and amended effective November 5, 1998 (Supp. 98-4). Amended by final rulemaking at 6 A.A.R. 3812, effective September 13, 2000 (Supp. 00-3). Amended by final rulemaking at 11 A.A.R. 1864, effective May 3, 2005 (Supp. 05-2). Former R4-21-208 renumbered to R4-21-209; new R4-21-208 renumbered from R4-21-206 and amended by final rulemaking at 14 A.A.R. 12, effective February 2, 2008 (Supp. 07-4). Amended by final rulemaking at 22 A.A.R. 328, effective March 28, 2016 (Supp. 16-1).