
Prescribers/Pharmacists
If you are unable to register to query data because the information submitted to the program does not match what the Division of Registrations contains in its licensing file, you will need to complete this form and submit via email or fax. Please remember to submit all required documents. Upon receipt of the documentation, the discrepancy will be corrected, and you will be informed when you can register to query data.
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1560 Broadway, Suite 1350, Denver, CO 80202 (303) 894-7800 - Phone (303) 894-7692 - Fax E-Mail