Section 391.5 - License application(a) Information on application.--An applicant for a license shall provide the following information on a license application form approved by the department: (1) The name, full business address and telephone number of the facility for which the applicant is seeking a license to operate.(2) The name, full business address and telephone number of the applicant.(3) All trade or business names used by the applicant.(4) Addresses, telephone numbers and the names of contact persons for all facilities used by the facility for which the license is being sought for the storage, handling and distribution of prescription drugs.(5) The type of ownership or operation, that is, partnership, corporation or sole proprietorship, of the facility.(6) The name of the owner and operator of the facility as follows:(i) If a sole proprietorship, the full name of the sole proprietor and the name of the business entity.(ii) If a partnership, the name of each partner and the name of the partnership.(iii) If a corporation, the name and title of each corporate officer and director, the corporate name and the name of the state of incorporation.(iv) If a person other than a sole proprietorship, partnership or corporation, the name of the person and of the individual in charge of that person.(7) Any other information required by the department, including information bearing upon whether there are grounds for refusing to grant the license under section 9. (b) Changes in information.--A change in any information provided in the application shall be submitted to the department within 30 days after the change or as otherwise required by the department.1992, Dec. 14, P.L. 1116, No. 145, § 5, imd. effective.