Application for permission to carry on business as a pharmacist form (PB139)

Use this form to apply for approval of a beneficiary of a deceased approved pharmacist, or by the legal personal representative of a deceased approved pharmacist.

This approval is under Section 90 or Section 91 of the National Health Act 1953.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 6 December 2018