Additional Practitioner Forms

Substitute Renewal

If you need a Substitute Renewal Form, please complete the following and return with payment:

• Practitional License Renewal Form

Inactive License

If you would like to make your license inactive, please complete the following and return with payment:

• Inactive Practitioner License Request

Duplicate License

Each license renewal is allowed one duplicate license only.

If you would like a duplicate license, please complete the following and return with payment:

• Duplicate Practitioner License Request

Certification Request

• Certification Request Form