bullred.gif (1398 bytes) Physician Locum Tenens
bullred.gif (1398 bytes) Applications
bullred.gif (1398 bytes) Board Information
bullred.gif (1398 bytes) Brochures
bullred.gif (1398 bytes) Certification/ Verification
bullred.gif (1398 bytes) Complaints
bullred.gif (1398 bytes) Contact Us
bullred.gif (1398 bytes) License Lookup
bullred.gif (1398 bytes) Licensee Assistance Program
bullred.gif (1398 bytes) Name and Address Change
bullred.gif (1398 bytes) Regulations
Statutes

Physician Locum Tenens
Applications

New Processing Information

These forms may be completed online, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form online, you must print the form and mail it to the address listed.

pdf icon Application for Locum Tenens Permit
pdf icon Request for License Verification form
pdf icon Requesting Physician Statement
pdf icon Deadlines for Board Review
pdf icon Shortage Area Statement

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Documents in PDF PDF format require the use of Adobe Acrobat Reader
which can be downloaded for free from Adobe Systems, Inc.