(a) Una solicitud de examen de reválida en el formulario que a estos fines le provea la Junta, en la forma y dentro del término que se disponga por reglamento.
(b) Evidencia acreditativa de que el solicitante cumple con los requisitos establecidos en los incisos (a), (b) y (c) de la sec. 409a de este título.
(c) Un documento oficial con retrato y firma que acredite la identidad del solicitante.
(d) El pago de los derechos de solicitud de examen de reválida para farmacéutica establecido en la sec. 409n de este título.
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