R9-16-215. Changes Affecting a License or a Licensee

A. A licensee shall submit to the Department a change application in a Department-provided format within 30 calendar days after the effective date of a change in: 1. The licensee’s home address or email address, including the new home address or email address; 2. The licensee’s name, including a copy of one of the following with the licensee’s new name: a. Marriage certificate, b. Divorce decree, or c. Other legal document establishing the licensee’s new name; and 3. The place or places, including address or addresses, where the licensee engages in the practice of audiology or speech-language pathology. B. A licensee may obtain a duplicate license updating the information requested in subsection (A) by submitting to the Department a change application in a format provided by the Department that includes: 1. The licensee’s name and address, 2. The licensee’s license number and expiration date, 3. The licensee’s signature and date of signature, and 4. The fee specified in R9-16-216. (Supp. 20-2).