R4-18-204. Specialist Certificates

To obtain a specialist certificate, a physician shall meet the requirements of A.R.S. Title 32, Chapter 14 and provide the Board: 1. A completed application form, provided by the Board that is signed, dated, and verified, which shall include the following information; a. Applicant’s full legal name; b. Current State of Arizona Naturopathic Physicians Medical License number; c. Email address, phone number, and mailing address; d. Name and address of the approved specialty college or program from which applicant completed postdoctoral specialty training; e. The specialty applicant received training in, and a copy of the certificate of completion received in the specialty; f. Who the specialty program was approved by; g. Whether applicant has a medical condition that in any way impairs or limits applicant’s ability to practice medicine; h. Whether applicant has ever been disciplined by any agency in any state or territory of the United States, for any act of unprofessional conduct as defined in A.R.S. § 32-1501; i. Whether applicant has ever had a naturopathic medical license or certification, or any other health profession license or certification denied, suspended, rejected or revoked by any agency in any state or territory of the United States, and; j. A detailed explanation and supporting documentation for each affirmative answer to questions regarding the applicant’s background; 2. The fees specified in R4-18-107 and; 3. A letter from the specialty board that conducted the specialty examination verifying that the licensee is certified as a specialists in the specialty for which application is made; 4. A certificate issued to a physician pursuant to A.R.S. § 32-1529(C), shall be concurrently renewed, retired, suspended, or revoked, with that physician’s license to practice naturopathic medicine.