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)