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Reset Form INDIANA BOARD OF PHARMACY PROFESSIONAL LICENSING AGENCY 402 West Washington Street Room W072 Indianapolis Indiana 46204 Telephone 317 234-2067 E-mail pla4 pla.IN.gov www. Is any action pending on any of the above CERTIFICATION By signing below you certify that you are not changing ownership pursuant to IC 25-26 or 856 IAC 1 and that you will remain compliant with all applicable statutes and regulations. INSPECT account Yes If yes provide INSPECT account number No NARRATIVE Please...
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Telephone 317 234-2067 is the contact number for the Department of Revenue in Indiana.
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