R4-43-202. Renewal of License

A. A licensee shall renew a license by submitting to the Board a renewal application, proof of completion of the continuing education requirements in R4-43-203, and paying the renewal fee within 2 years of initial licensure or last license renewal date. B. The renewal application form provided by the Board shall include the following: 1. Applicant’s last name, first name, middle initial, and other names used by the applicant; 2. How applicant’s name is to be shown on the renewal license; 3. Residence address; 4. Alternate mailing address if the residential address is to remain confidential; 5. Current Arizona Board of Occupational Therapy Examiners license number; 6. Type of renewal license for which applying; 7. The amount of the renewal fee; 8. Disciplinary actions since initial licensure; 9. Hours and titles of continuing education completed; 10. Total hours of continuing education completed; 11. Social security number; 12. Employer’s name, address, and telephone number; 13. Signature and date. C. Unless otherwise required by A.R.S. § 32-3202, a license that is not renewed within 2 years of the date of issuance expires by operation of law. A licensee may reinstate within 180 calendar days of the expiration date upon payment of the required renewal fee, a reinstatement fee under R4-43-102(A)(2)(a) and submittal of proof of completion of the continuing education requirements in R4-43-203.