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Healthy Communities

Radiologic Technology 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.

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

Public Health Accrediation Board
Arkansas Department of Health
© 2017 Arkansas Department of Health. All Rights Reserved.
4815 W. Markham, Little Rock, AR 72205-3867