Medical License Name Change

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NYS Licensed Professions - General Licensing Information

https://www.op.nysed.gov/about/general-information-policies

To file a change of name: Please complete our Name Change Form (600 KB) and mail it to the address at the end of the form, including the supporting documentation. Once you are licensed, Education Law requires that you notify the Department of any …

Complications for When Physicians Change …

https://www.enttoday.org/article/complications-for-when-physicians-changing-a-maiden-name/

When Leslie Williamson, MD, wed nearly four decades ago, changing her maiden name to her …

State Medical Board of Ohio > FAQs > Renewal FAQs

https://med.ohio.gov/FAQs/Renewal-FAQs

Within the drop-down menu, click “Change Name” On the next page enter all required information. Click “Save and upload documents” Upload one of the following documents …

Medical Licensing Information - PLA

https://www.in.gov/pla/professions/medical-physicians-and-osteopathic-physicians-home/medical-licensing-information/

If you change your name after you have submitted an application, or if any documents you submit for your application have a different last name than your current last name, you …

Notification of Name Change - California

https://www.mbc.ca.gov/Download/Forms/nc-1.pdf

New First Name New Middle Name New Last Name Last Four of SSN# License # Date of Birth (MM/DD/YYYY) SECTION B: DOCUMENTATION REQUIREMENTS AND …

Florida Board of Medicine » How do I change my name?

https://flboardofmedicine.gov/help-center/how-do-i-change-my-name/

Name changes require legal documentation showing the name change. To change your name, please submit supporting documents, which must be one of the following: A copy …

Virginia Board of Medicine

https://www.dhp.virginia.gov/Boards/Medicine/PractitionerResources/UpdateYourInformation/

You must submit a copy of a legal document verifying your new name. The following are acceptable name change verification documents: Marriage certificate; Divorce decree …

Change your Contact, Address, Name or Personal …

https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/change-your-contact-address-name-or-personal-status-information

Change your Contact, Address, Name or Personal Status Information Change your Contact, Address, Name or Personal Status Information We must have your current …

Licensing - Nebraska Department of Health & Human …

https://dhhs.ne.gov/licensure/Pages/Licensing-Home-Page.aspx

Change my name on my professional license Change my address (not for a business) Obtain a certification or verification of a license File a complaint View disciplinary actions …

Change of Address/Name - North Carolina Medical Board

https://www.ncmedboard.org/resources-information/professional-resources/online-services/individual-services/change-of-address

Download the form here and mail or fax it to the Board’s office. It is not necessary to do both. Licensees will receive an updated copy of their certificate via email, if a valid email dress …

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