3-29-23 CEU Form Name First Last Street Address* City* State* Zip* Phone*Email* Profession Type*Pharmacist/Pharmacy TechNurseAdministratorLicense Number* For pharmacists/pharmacy techs*If you’d like your hours uploaded to CPE Monitor, please include your NABP number and DOB (mm/dd) Did the speaker achieve the goals and objectives provided for this program?*YesNoWill the information presented benefit you in your daily practice?*YesNoAdditional commentsPlease share any additional information you’d like to share from your participation in this activity. Δ
