Licensees

Physician and Surgeon Renewal Forms and Information

• License Renewal Application (Downloadable)
• OMB.29 Form Certification of 36 months of Postgraduate Training for Renewal
• Code of Ethics
• Continuing Medical Education
• Activate License

Fictitious Name Permits

• Fictitious Name Permit
• Fictitious Name Permit Address Change Form

Other Forms

• Instructions and Application for Disabled Placard or Plate
• Name and Gender Change Notification and Request for Confidentiality (SB 372, 2023)

Pocket License

The Board is no longer issuing pocket licenses upon the approval of an renewal application. Licensees can print a pocket license by logging into their BreEZe account and selecting either "Print License Certificate – Osteo Pocket Cert - Active" -or- "Print License Certificate – Osteo Pocket Cert - Inactive " (for licensees who hold a Current/Inactive License) from the drop-down menu under the "Manage Your License Information" section. Once selected, the pocket license certificate will open as a PDF on a separate tab.

Resources

• Controlled Substance Prescribing
• Diversion Program Information
• Guidelines for the Recommendation of Cannabis for Medical Purposes
• Infection Control Guidelines
• Naloxone
• Rescheduling Hydrocodone
• Sample letter for SB 1448
• Section 317 Policy Change – Letter to Healthcare Providers
• Telemedicine
• Workers' Compensation Fraud Warning Notice 2017

CURES

• CURES
• Renewal Fee Increase SB 809

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