846 IAC 1-4-6 Loss, destruction, or theft of license; change of name

Sec. 6. (a) The licensee shall report to the board, on the form supplied by the board, the loss, destruction or theft of the original certificate of licensure or the biennial renewal pocket card, and pay a fee of ten dollars ($10) for a duplicate. (b) If a change of name is requested, the licensee shall submit a notarized copy of a marriage license, divorce decree or court order to the board. Upon receipt of the documentation of the name change, and payment of the ten dollar ($10) fee, the board shall issue a new certificate and biennial renewal pocket card.