Applications and forms
Initial Licensure Applications
Reactivation Applications *
(*Expired or inactive licenses)
Name and/or Address Change (Address change can be made online)
Radiology Authorization Name and/or Address Change (with or without a request for a duplicate)
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.