Verification Information
New Applicants
- Verification of licensure must be provided to the Board for every state in which you are, or have been licensed, certified, or otherwise registered to practice as a healthcare provider, regardless of the license status.
- Each licensing agency must then mail an original, completed verification, with their agency seal, directly to the Board.
- Electronic verifications are only acceptable from those states that do not provide paper verification.
- The Board will not accept verifications received by fax or email.
- Courtesy Verification Request Form (PA7)