Compliance Inspection Report Page 2
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11PHARMACY STAFFING
PHARMACY STAFF PRESENT AT TIME OF INSPECTION
PHARMACISTS
LICENSE#
CURRENT?
1
□ YES □ NO
2
□ YES □ NO
3
□ YES □ NO
4
□ YES □ NO
5
□ YES □ NO
6
□ YES □ NO
PHARMACY INTERNS
LICENSE#
CURRENT?
1
□ YES □ NO
2
□ YES □ NO
3
□ YES □ NO
PHARMACY TECHNICIANS
CERTIFIED?
LICENSE#
CURRENT?
1
□ YES □ NO
□ YES □ NO
2
□ YES □ NO
□ YES □ NO
3
□ YES □ NO
□ YES □ NO
4
□ YES □ NO
□ YES □ NO
5
□ YES □ NO
□ YES □ NO
6
□ YES □ NO
□ YES □ NO
7
□ YES □ NO
□ YES □ NO
8
□ YES □ NO
□ YES □ NO
9
□ YES □ NO
□ YES □ NO
10
□ YES □ NO
□ YES □ NO
OTHER PHARMACY STAFF including trainees
POSITION
TRAINEE HOURS
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2
3
4
2
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