Name change (PDF) - Will be made only when a copy of an official document (marriage certificate, divorce decree or court order) is submitted with a letter of request. **For confirmation, you must request a duplicate license. The fee for a duplicate license is $5.00 (check or money order) payable to the Commonwealth of PA.
Address change (PDF) - Written requests should include the old address, new address and license number and/or social security number. (Also available to submit online.) The Board must be notified within 10 days of any change in address. There is no fee to change your address in the Board's records. For confirmation, include a check for $5.00 to have a duplicate license sent to your new address.
Verification of licensure to another state *- request ONLINE NOTE: As a result of document fraud and in an effort to protect its licensees, the Board will only provide direct source verification of your license to another state licensing agency.
*Notification Regarding Online LOGS Request (PDF)