Applicants for renewal of an out of state contact lens dispenser registration shall provide the following on a form supplied by the board:

1. (a) Name and address of business;
2. (b) Telephone number of business;
3. (c) Signature of principal business owner; and
4. (d) Any changes from the original application as identified in Opt 304.01.

Source. #12383, eff 9-16-17 (formerly Opt 304.04)