Reinstatement Applications

 

The renewal period for medical doctors whose last names begin with the letters A through L, controlled substance dispensing practitioners whose last names begin with the letters A through L, and professional limited liability companies concluded at 4:30 pm EDT on September 30, 2020. In addition, the renewal period for physician assistants ended March 31, 2021.  If a license, registration or authorization expired on September 30, 2020 or March 31, 2021 due to lack of renewal, the practitioner and/or company may apply for reinstatement within one year of the expiration date. Instructions and applications are available below.

Original signatures are required, therefore, applications are not accepted via facsimile or email.

Medical Doctor (A-L) License Reinstatement Application                      

Physician Assistant Reinstatement Application                                     

Controlled Substance Dispensing Practitioner Registration Application

Professional Limited Liability Company Application