Licensure Forms

Fill out the appropriate application or renewal form, electronically if available. Sign the form where appropriate and mail it along with any applicable fee to the address indicated on the form. Other forms are as indicated below.

Downloads

• Application for Licensure
• Inactive-Retired Status Request Form
• License Renewal Form
• Licensure Verification Form
• Limited Scope Examination Application
• Temporary Diagnostic CT License for Nuclear Medicine Technologists
• Temporary Application for Licensure