Change of Address - Podiatrist

You cannot make changes to a drug dispensing location with this form. In order to make changes to a drug dispensing location, you must submit the appropriate application to the Board. If only updating e-mail address information you may e-mail the update to bomnewsletter@wv.gov .

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Please include hyphens and
spaces if applicable.
Please do not add preceding zeros
when you input your License Number.