IN.gov - Skip Navigation

Note: This message is displayed if (1) your browser is not standards-compliant or (2) you have you disabled CSS. Read our Policies for more information.

Indiana Professional Licensing Agency

PLA > Professions > Board of Podiatric Medicine > Application & Instruction for Controlled Substance Registration Application & Instruction for Controlled Substance Registration

You will need Adobe Reader to open this document. Download a free copy at www.adobe.com

APPLICATION Instructions

NOTE: The current application fee is sixty dollars ($60).

PRACTIONERS

Use the top half of application. Applicants must have an active Indiana professional license before they can obtain an Indiana CSR. A physician or an osteopathic physician who is practicing with an Indiana temporary medical license is not eligible for a CSR until he/she receives a permanent license. A practitioner must hold one CSR in order to prescribe controlled substances in the State of Indiana. An additional, separate registration is required for each practice address at which a practitioner physically possesses controlled substances to administer or dispense. A separate registration is NOT required for each place where a practitioner merely prescribes controlled substances. One valid CSR is sufficient for a practitioner to prescribe controlled substances throughout the State.

Applicants MUST use an Indiana practice address when applying for a CSR. The CSR can only be mailed to the address submitted on the application. A CSR will only be issued to a street address; post office boxes will not be acceptable unless accompanied by a street address. An application with an incomplete or out of state address will be returned. Registrants must notify the Professional Licensing Agency in writing of any change of address.

What schedules to request: Practitioners usually apply for authorization for Schedules II through V, as Schedule I controlled substances have no accepted medical use and are generally restricted to researchers only.

Don't forget to include the application fee ($60) with a check made payable to the Professional Licensing Agency. Note that this fee has recently been changed.

ADDITIONAL INFORMATION PERTAINING TO CSR's

Drug Enforcement Administration: Practitioners and Non-practitioners may apply for the Drug Enforcement Administration (DEA) registration at the same time as the State CSR; please indicate "pending" where the DEA requests the State license number. The Professional Licensing Agency verifies CSR numbers to the DEA once they are issued. The Professional Licensing Agency does not have DEA forms. For information regarding the DEA registration please contact the DEA Indianapolis Field Office at 575 North Pennsylvania Street, Indianapolis, IN 46204 or by telephone at (317) 226-7977.

Renewals: Each registrant will receive a renewal for the CSR at the same time that he or she renews his or her professional license with the Professional Licensing Agency. Non-practitioners will receive a renewal application during the first week of November in odd-numbered years. It is the responsibility of the registrant to renew the CSR. Renewal applications for CSRs are mailed 60 days prior to the expiration of the permit. If you do not receive your renewal application at that time, please call our office at (317) 234-2064 to request a duplicate application.

Address Change: You are required to notify the Professional Licensing Agency of any address changes. Controlled substances registrations are issued for a particular purpose at a specified location. Any change of address for practitioners must be reported to the Professional Licensing Agency and to the appropriate professional licensing board. Your written notice must include your name, license number, profession, social security number, date of birth, and both your old and new addresses. Please send the information to:

Indiana Professional Licensing Agency
402 West Washington Street, Room W072
Indianapolis, Indiana 46204

You may also send changes to us via fax at (317) 233-4236 or via email at pla5@pla.IN.gov. Be sure to include your license number. CSRs issued to a facility are non-transferable. Prior to the planned move, a facility must obtain and complete a new application for controlled substances registration. An inspection will also be required prior to storing, dispensing, or administering controlled substances at the facility. Those wishing to schedule an inspection can call at (317) 232-2960 for additional information.

Name Change: You may have the name changed on your licensure records by submitting a copy of an official name change document such as a marriage certificate or a divorce decree. A copy of a social security card will NOT be accepted. Please send the information to:

Indiana Professional Licensing Agency
402 West Washington Street, Room W072
Indianapolis, Indiana 46204

Your letter should include your name as it is listed now, your new name, your license number, profession, social security number, and date of birth. If you want us to send you a new pocket card, please indicate in the letter that a new card is needed due to the name change.

Once your application file is complete, including any verification from other states or boards, it will be reviewed by your licensing Board or Board staff for approval. Note that if you have given a positive response to any of the questions pertaining to past disciplinary or legal action, you must supply additional, notarized information with your application as requested.

For questions about this application, please contact (317) 234-2064 or email us at pla5@pla.IN.gov.