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Missouri Pharmacist — Requirements & Free Practice

US-MO · License preparation

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Pharmacist License

Missouri license to practice as a pharmacist.

Licensing authority: Missouri Board of Pharmacy · Application information

Licensure by examination for graduates of an ACPE accredited U.S. pharmacy school or college

All of the following:

Completion Window
Pass both examinations within two years after submitting the licensure application
Education
Graduate of an ACPE-accredited pharmacy school or college
Practice Experience
1,500 hours as accepted under 20 CSR 2220-7.030
Licensure by examination for graduates of a pharmacy school or college outside the United States or its territories

All of the following:

Certification
Valid FPGEC certification is required before applying for the Missouri pharmacist license
Completion Window
Pass required examinations within two years after submitting the licensure application
Education
Graduate of a pharmacy school or college outside a U.S. state or territory
Practice Experience
1,500 qualifying hours earned in a U.S. state or territory after FPGEC certification, or at least one year maintaining an active pharmacist license in another U.S. state or territory
General out of state license recognition under RSMo §324.009
Multistate Pharmacy Jurisprudence Examination for Missouri (practice unavailable)
Current License
Valid current license in the same occupation and practice level from another state, a military branch or unit, a U.S. territory, or the District of Columbia, held for at least one year
Equivalence Review
The issuing jurisdiction verifies that the applicant met its minimum education and applicable work-experience and clinical-supervision requirements
Exclusions
No current disqualifying discipline, investigation, complaint, unresolved discipline, disqualifying criminal record, or interstate-compact-only license; other statutory exclusions remain applicable
License transfer or reciprocity under RSMo §338.040 and 20 CSR 2220 7.050
Multistate Pharmacy Jurisprudence Examination for Missouri (practice unavailable)
Current License
Currently registered or licensed as a pharmacist in another U.S. state or territory and licensed there by examination
Equivalence
Qualifications and competence standards must satisfy RSMo §338.040
Foreign Graduates
Must also satisfy 20 CSR 2220-7.040 and provide valid FPGEC certification
Practice Experience
1,500 hours of pharmacy practice experience or at least one year maintaining an active pharmacist license in the transferring state
License recognition for a qualifying military or law enforcement spouse under RSMo §324.009
No examination is required for this applicant pathway.
Current License
Valid current license in the same occupation and practice level from another qualifying jurisdiction, held for at least one year
Other Requirements
Must otherwise meet RSMo §324.009, including its good-standing and disqualification provisions
Spouse Status
Resident or nonresident military or law-enforcement spouse as defined by RSMo §324.009

Official no-examination sources

Effective from 2026-08-28.

Licensure by examination using a NAPLEX score transferred from another jurisdiction

All of the following:

Naplex Score
Passing NAPLEX score transferred to Missouri through NABP
Other Requirements
Must satisfy the otherwise applicable Missouri pharmacist licensing and application requirements
Score Validity
Transferred NAPLEX score is valid for five years

Multistate Pharmacy Jurisprudence Examination for Missouri

Provider
National Association of Boards of Pharmacy
Format
Computer-based adaptive selected-response examination
Exam questions
120
Time limit
2.5 hours
Passing score
75
Examination outline
  • Pharmacy Practice (83%)
    • Legal responsibilities of the pharmacist and other pharmacy personnel
    • Unique legal responsibilities of the pharmacist-in-charge (or equivalent), pharmacists, interns, and pharmacy owners
    • Qualifications, scope of duties, and conditions for practice relating to pharmacy technicians and all other non-pharmacist personnel
    • Requirements for the acquisition and distribution of pharmaceutical products, including samples
    • Requirements and record keeping in relation to the ordering, acquiring, and maintenance of all pharmaceutical products and bulk drug substances/excipients
    • Requirements for distributing pharmaceutical products and preparations, including the content and maintenance of distribution records
    • Legal requirements that must be observed in the issuance of a prescription/drug order
    • Prescription/order requirements for pharmaceutical products and the limitations on their respective therapeutic uses
    • Scope of authority, scope of practice, and valid registration of all practitioners who are authorized under law to prescribe, dispense, or administer pharmaceutical products, including controlled substances
    • Conditions under which the pharmacist participates in the administration of pharmaceutical products, or in the management of patients’ drug therapy
    • Requirements for issuing a prescription/order
    • Requirements for the issuance of controlled substance prescriptions/orders
    • Limits of a practitioner’s authority to authorize refills of a pharmaceutical product, including controlled substances
    • Procedures necessary to properly dispense a pharmaceutical product, including controlled substances, pursuant to a prescription/drug order
    • Responsibilities for determining whether prescriptions/orders were issued for a legitimate medical purpose and within all applicable legal restrictions
    • Requirements for the transfer of existing prescription/order information from one pharmacist to another
    • Conditions under which a prescription/order may be filled or refilled
    • Conditions under which prospective drug use review is conducted prior to dispensing
    • Conditions under which product selection is permitted or mandated
    • Requirements for the labeling of pharmaceutical products and preparations dispensed pursuant to a prescription/order
    • Packaging requirements of pharmaceutical products, preparations, and devices to be dispensed pursuant to a prescription/order
    • Conditions under which a pharmaceutical product, preparation, or device may not be dispensed
    • Requirements for compounding pharmaceutical products
    • Requirements for emergency kits
    • Conditions regarding the return and/or reuse of pharmaceutical products, preparations, bulk drug substances/excipients, and devices
    • Procedures and requirements for systems or processes whereby a non-pharmacist may obtain pharmaceutical products, preparations, bulk drug substances/excipients, and devices
    • Procedures and requirements for establishing and operating central processing and central fill pharmacies
    • Requirements for reporting to PMP, accessing information in a PMP and the maintenance of security and confidentiality of information accessed in PMPs
    • Requirements when informed consent must be obtained from the patient and/or a duty to warn must be executed
    • Conditions for making an offer to counsel or counseling appropriate patients, including the requirements for documentation
    • Requirements to counsel or to make an offer to counsel
    • Required documentation necessary for counseling
    • Requirements for the distribution and/or dispensing of non-prescription pharmaceutical products, including controlled substances
    • Requirements for the labeling of non-prescription pharmaceutical products and devices
    • Requirements for the packaging and repackaging of non-prescription pharmaceutical products and devices
    • Requirements for the distribution and/or dispensing of poisons, restricted, non-prescription pharmaceutical products, and other restricted materials or devices
    • Procedures for keeping records of information related to pharmacy practice, pharmaceutical products and patients, including requirements for protecting patient confidentiality
    • Requirements pertaining to controlled substance inventories
    • Content, maintenance, storage, and reporting requirements for records required in the operation of a pharmacy
    • Requirements for protecting patient confidentiality and confidential health records
    • Requirements for handling hazardous materials such as described in USP <800>
    • Requirements for appropriate disposal of hazardous materials
    • Requirements for training regarding hazardous materials
    • Environmental controls addressing the proper storage, handling, and disposal of hazardous materials
    • Methods for the compounding, dispensing and administration of hazardous materials
  • Licensure, Registration, Certification, and Operational Requirements (15%)
    • Qualifications, application procedure, necessary examinations, and internship for licensure, registration, or certification of individuals engaged in the storage, distribution, and/or dispensing of pharmaceutical products (prescription and non-prescription)
    • Requirements for special or restricted licenses, registration, authorization, or certificates
    • Standards of practice related to the practice of pharmacy
    • Requirements for classifications and processes of disciplinary actions that may be taken against a registered, licensed, certified, or permitted individual
    • Requirements for reporting to, and participating in, programs addressing the inability of an individual licensed, registered, or certified by the Board to engage in the practice of pharmacy with reasonable skill and safety
    • Requirements and application procedure for the registration, licensure, certification, or permitting of a practice setting or business entity
    • Requirements for registration, license, certification, or permitting of a practice setting
    • Requirements for an inspection of a licensed, registered, certified, or permitted practice setting
    • Requirements for the renewal or reinstatement of a license, registration, certificate, or permit of a practice setting
    • Classifications and processes of disciplinary actions that may be taken against a registered, licensed, certified, or permitted practice setting
    • Operational requirements for a registered, licensed, certified, or permitted practice setting
    • Requirements for the operation of a pharmacy or practice setting that is not directly related to the dispensing of pharmaceutical products
    • Requirements for the possession, storage, and handling of pharmaceutical products, preparations, bulk drug substances/excipients, and devices, including controlled substances
    • Requirements for delivery of pharmaceutical products, preparations, bulk drug substances/excipients, and devices, including controlled substances
  • General Regulatory Processes (2%)
    • Application of regulations
    • Laws and rules that regulate or affect the manufacture, storage, distribution, and dispensing of pharmaceutical products, preparations, bulk drug substances/excipients, and devices (prescription and non-prescription), including controlled substances
Examination sources

North American Pharmacist Licensure Examination

Provider
National Association of Boards of Pharmacy
Format
Computerized fixed form
Exam questions
225 questions
Time limit
6 hours
Passing score
Pass or Fail
Examination outline
  • Foundational Knowledge for Pharmacy Practice (25%)
    • Pharmaceutical science principles and concepts
    • Pharmaceutical science principles and concepts: Pharmacology
    • Pharmaceutical science principles and concepts: Pharmacokinetics, pharmacodynamics, or pharmacogenomics
    • Pharmaceutical science principles and concepts: Pharmaceutics
    • Pharmaceutical compounding
    • Pharmaceutical compounding: Nonsterile preparations
    • Pharmaceutical compounding: Sterile preparations
    • Pharmaceutical calculations
    • Pharmaceutical calculations: Patient parameters or laboratory measures
    • Pharmaceutical calculations: Quantities of drugs to be dispensed or administered
    • Pharmaceutical calculations: Rates of administration
    • Pharmaceutical calculations: Dose conversions
    • Pharmaceutical calculations: Drug concentrations, ratio strengths, osmolarity, or osmolality
    • Pharmaceutical calculations: Quantities of drugs or ingredients to be compounded
    • Pharmaceutical calculations: Nutritional needs and the content of nutrient sources
    • Pharmaceutical calculations: Biostatistical, epidemiological, or pharmacoeconomic measures
    • Pharmaceutical calculations: Pharmacokinetic parameters
    • Drug development processes (eg, clinical trial phases, emergency use authorizations)
    • Research design principles and biostatistics (eg, blinding, randomization, biases, statistical tests and outcomes, ethics)
    • Retrieval, assessment, and interpretation of primary, secondary, and tertiary resources
  • Medication Use Process (Prescribing, Transcribing and Documenting, Dispensing, Administering, and Monitoring) (25%)
    • Prescriptions and medication order interpretation
    • Prescriptions and medication order interpretation: Drug names and therapeutic classes
    • Prescriptions and medication order interpretation: Indications, usage, and dosing regimens
    • Prescriptions and medication order interpretation: Available dosage forms
    • Prescriptions and medication order interpretation: Prescription regulations (eg, boxed warnings, risk evaluation and mitigation strategies)
    • Prescriptions and medication order interpretation: Safety and effectiveness (eg, laboratory parameters, vital signs)
    • Therapeutic substitutions (eg, formulary restrictions, therapeutic alternatives, shortages, biosimilars)
    • Immunization services and documentation
    • Immunization services and documentation: Indications and scheduling
    • Immunization services and documentation: Contraindications and precautions
    • Immunization services and documentation: Storage and handling
    • Immunization services and documentation: Administration (eg, techniques, preparation, routes)
    • Immunization services and documentation: Adverse reactions
    • Medication handling, storage, stability, and disposal (eg, hazardous and nonhazardous drugs, controlled substances, parenteral medications, sharps handling, temperature control)
  • Person-Centered Assessment and Treatment Planning (40%)
    • Medication history, allergy history, and reconciliation
    • Health histories, screenings, and assessments
    • Patient health conditions, including special populations and medication-related factors
    • Patient health conditions, including special populations and medication-related factors: Signs, symptoms, and findings of medical conditions, etiology of diseases, or pathophysiology
    • Patient health conditions, including special populations and medication-related factors: Appropriateness of therapy (eg, medications, immunizations, non-drug therapy, dosing, contraindications, warnings, evidence-based decision making)
    • Patient health conditions, including special populations and medication-related factors: Interactions (eg, drug-drug, drug-condition, drug-food, drug-allergy, drug-laboratory)
    • Patient health conditions, including special populations and medication-related factors: Errors and omissions (eg, dosing, duplication, additional therapy needed, unnecessary therapy)
    • Patient health conditions, including special populations and medication-related factors: Adverse drug reactions
    • Patient health conditions, including special populations and medication-related factors: Toxicologic exposures and overdoses
    • Patient health conditions, including special populations and medication-related factors: Adherence
    • Therapeutic monitoring, plan development, evaluation, and modifications
    • Therapeutic monitoring, plan development, evaluation, and modifications: Therapeutic goals, clinical endpoints, and follow-up
    • Therapeutic monitoring, plan development, evaluation, and modifications: Safety
    • Therapeutic monitoring, plan development, evaluation, and modifications: Effectiveness
    • Patient education
    • Patient education: Lifestyle modifications and health maintenance
    • Patient education: Medication use, storage, and disposal
    • Patient education: Disease state management
    • Over-the-counter medications and dietary supplements
    • Devices to administer medications and self-monitoring tests
  • Professional Practice (5%)
    • Adverse drug event reporting and medication error reporting (eg, MedWatch, VAERS)
    • Public health initiatives and risk-prevention programs (eg, tobacco and nicotine cessation, antimicrobial stewardship, health screenings, opioid stewardship)
    • Social determinants and drivers of health
    • Ethical considerations (eg, informed consent, ethical principles, professional conduct and responsibility, patient confidentiality)
  • Pharmacy Management and Leadership (5%)
    • Pharmacy operations (eg, operational planning, risk management, regulations and regulatory bodies, technology applications and informatics, error-prevention strategies, medication safety)
    • Inventory and supply management (eg, drug recalls, drug shortages)
    • Quality improvement activities (eg, medication use evaluation, root-cause analysis, continuous quality improvement)
    • Mentorship and preceptorship (eg, providing and receiving feedback, delegation of work activities, preceptor roles)
Examination sources