California License Transfer and form 17A-16

[Nightshade8699]

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Hello everyone!

I have been licensed and working as a pharmacist in Washington state since 2015. I am moving to CA early next year and am transferring my license. The instructions for form 17A-16 are pretty bad in the CA form on what needs to be filled out. I know my intern hours don't need to be validated because I have been licensed for well over 1 year, but the form really doesn't seem designed for that to be done clearly....even though the application instructions say this.

Here is my license history all held in WA:

Pharmacist (active and in good standing since 2015)
Intern (superseded)
Assistant (expired)

Will CA only need one 17A-16 filled out by my state board validating my current pharmacist license? Or do they need a form for each past license held in WA? It would make zero sense for the latter, but I just want to be sure before I mail in the documents. I have emailed and called the CA board to get clarification, but they seem incapable of responding to anything....so I am hoping someone who has gone through this can help. Thanks!

 

[Sine Cura]

This form must be completed by the licensing agency in each state you hold or held an individual license (e.g. pharmacist, intern pharmacist, pharmacy technician, designated representative, and/or another healthcare professional license) even if the license is no longer current or active. Please return the original state-verified form with your application for each license type. Photocopies or faxes will not be accepted.

Why wouldn't it make sense? If there was any disciplinary action, the licensing board would want to know.