Change Of Name And/Or Address

The name and address contained in the applicant’s license application shall be the name and address of the licensee where all correspondence and renewal forms from the Board shall be sent. (1) Change of Name - An individual licensed by the Board shall notify the Board in writing within thirty (30) days of a name change and will provide both the old and new names. A request for name change must also include a copy of the official document involved and reference the individual’s profession, board, social security and license numbers. (2) Change of Physical Address - Each person holding a license who has had a change of address, shall file in writing with the Board his current address, giving both old and new addresses. Such requests shall be received in the Board office no later than thirty (30) days after such change is effective and must reference the individual’s name, profession, board, social security and license numbers. (3) Change of Email Address - Each person holding a license who has had a change of email address shall file in writing with the Board his current email address. Such requests shall be received in the Board office no later than thirty (30) days after such change is effective and must reference the individual’s name, profession, board, social security and license numbers. (4) Requests submitted under this rule may be submitted to the Board’s administrative office by mail or email or may be uploaded by the licensee to the licensee’s online account.