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A City, OK 73105-3455 Phone: 405-521-3815 / Fax: 405-521-3758 e-mail: pharmacy osbp.state.ok.us www.pharmacy.state.ok.us Reset Form Designation Tag Order Form Ship To: Quantity Description "Pharmacist" Tag "Rx Tech" Tag "Intern" Tag Please return completed order form to the Board at the above address. Tags are provided at no cost while supplies last. Postage will be invoiced upon shipment. Payment of postage is due upon receipt. Please do not send cash. Make checks payable to: Oklahoma Stat.

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