Medical Doctor Applications

**NOTICE**

In order to comply with federal law, the West Virginia Board of Medicine is obligated to inform each applicant or licensee from whom it requests a Social Security Number that disclosing such number is MANDATORY in order for this Board to comply with the reporting requirements of the National Practitioner Data Bank.

 

To apply for an initial license or to reactivate a license that has been expired for more than one year please complete the Uniform Application.

To apply for reinstatement of a license which expired on June 30, 2021 or to apply to change an inactive status license to active status please access the appropriate application below.

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

LICENSE REINSTATEMENT APPLICATION (M -Z) - vailid until June 30, 2022         
CHANGE OF STATUS APPLICATION (A - L) - valid until June 30, 2022                    
CHANGE OF STATUS APPLICATION (M - Z) - vaild until June 30, 2023