As a prescriber, you need to use Form 224. I applied for schedule II to V prescribing. You just need any permanent state license, a state controlled license number (if applicable), and $731. The number will be good for 3 years. Your address will need to be the same as your state license. The DEA website states: “Your home address is acceptable IF it is the location of your professional practice.” Technically, your new practice address IS the interim location of your professional practice. You just don’t happen to see any patients currently. I used my home address when I applied in 2010. My DEA certificate arrived in the mail within 2 to 3 weeks.