If you had a misdemeanor or felony conviction (other than a minor traffic violation) or had your license in any health care profession in another state revoked, suspended, limited or disciplined in any manner, you must request the following documents be sent directly to this office:
- Official Court Record, which includes charges and disposition;
- If the conviction involved a drug and/or alcohol related offense, all addiction/mental health evaluations and proof of treatment (if treatment was obtained and/or required);
- If you are currently on probation, a letter from your probation officer addressing probationary conditions and your current status; and
- If your license in health care in another state has been revoked, suspended, limited or disciplined in any way, an official copy of the disciplinary action, including charges and disposition.
NOTE: If you have any criminal charges or license disciplinary actions pending that results in conviction or license discipline, you are required to report such actions to this department within 30 days.
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