36-11A-28. Information to be provided by applicants.
The board shall require the following minimum information from each wholesale distributor applying to obtain a license under §36-11A-27:
(1)The name, full business address, and telephone number of the licensee;
(2)Any trade or business name used by the licensee;
(3)The address, telephone number, and the name of any contact person for any facilities used by the licensee for the storage, handling, and distribution of prescription drugs;
(4)The type of ownership or operation;
(5)The name of the owner and the operator of the licensee, including:
(a)If a person, the name of the person;
(b)If a partnership, the name of each partner, and the name of the partnership;
(c)If a corporation, the name and title of each corporate officer and director, the corporate names, and the name of the state of incorporation; and
(d)If a sole proprietorship, the full name of the sole proprietor and the name of the business entity;
(6)A list of all licenses and permits issued to the applicant by any other state that authorizes the applicant to purchase or possess prescription drugs;
(7)The name of the applicant's designated representative for the facility, together with the personal information statement and fingerprints, required pursuant to subdivision (8) for such person;
(8)Each person required by subdivision (7) to provide a personal information statement and fingerprints, if required, shall provide the following information to the board:
(a)The person's places of residence for the past seven years;
(b)The person's date and place of birth;
(c)The person's occupations, positions of employment, and offices held during the past seven years;
(d)The principal business and address of any business, corporation, or other organization in which each such office of the person was held or in which each such occupation or position of employment was carried on;
(e)Whether the person has been, during the past seven years, the subject of any proceeding for the revocation of any license or any criminal violation and, if so, the nature of the proceeding and the disposition of the proceeding;
(f)Whether, during the past seven years, the person has been enjoined, either temporarily or permanently, by a court of competent jurisdiction from violating any federal or state law regulating the possession, control, or distribution of prescription drugs or had any criminal violations of such laws, together with details concerning any such event;
(g)A description of any involvement by the person with any business, including any investments, other than the ownership of stock in a publicly traded company or mutual fund, during the past seven years, which manufactured, administered, prescribed, distributed, or stored pharmaceutical products and any lawsuits in which such businesses were named as a party;
(h)A description of any misdemeanor or felony criminal offense of which the person, as an adult, was found guilty, regardless of whether adjudication of guilt was withheld or whether the person pled guilty or nolo contendere. If the person indicates that a criminal conviction is under appeal and submits a copy of the notice of appeal of that criminal offense, the applicant shall, within fifteen days after the disposition of the appeal, submit to the board a copy of the final written order of disposition; and
(i)A photograph of the person taken in the previous one hundred eighty days.
The information required pursuant to this section shall be provided under oath.
Source: SL 2007, ch 215, §10.