Missouri Pharmacy Practice Act, Board Rules, and Scope of Practice
Where the law comes from
Missouri pharmacy practice is governed by Chapter 338, RSMo, and the rules the Board of Pharmacy adopts, codified at 20 CSR 2220. The Board sits within the Division of Professional Registration (Department of Commerce and Insurance) and is composed of pharmacist and public members appointed by the Governor. It licenses pharmacists, pharmacies, interns, technicians, and drug distributors, investigates complaints, and disciplines licensees. It cannot, however, enlarge the scope of practice the legislature wrote into the statute - a rule that conflicts with Chapter 338 is unenforceable, a favorite exam trap.
What "practice of pharmacy" covers
Interpreting and evaluating prescriptions, compounding and dispensing, drug utilization review, patient counseling, administering immunizations and other authorized drugs, and collaborative practice. Distinguish dispensing (lawful transfer of possession pursuant to a valid prescription) from administering (delivering drug into the patient's body). Know who may do what: registered technicians work under pharmacist supervision and cannot perform final verification of a filled prescription; interns perform pharmacist tasks only under supervision.
Discipline and discretion
Grounds include fraud in obtaining a license, unprofessional conduct, incompetence, impairment, and violating Board orders. A pharmacist may decline to fill on professional judgment, but the reason must be clinical or legal and should be documented - not convenience or corporate policy.
Rule of thumb: read the statute for who may do what; read the rule for how it must be documented. Worked example: A chain's internal policy lets technicians verify refills. The statute and rule still require pharmacist verification; the policy loses.