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State Board of Medicine
  Licensure Information
 

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Board Services
 
Rules and regulations - Available from Board office upon request.  Remember to include your mailing address with your request.
 
Name change - Will be made only when a copy of an official document (marriage certificate, divorce decree or court order) is submitted with a letter of request.  The fee for a duplicate license is $5.00 (check or money order) payable to the Commonwealth of PA.
 
Address change - Written requests should include the old address, new address and license number and social security number.  The Board must be notified within 10 days of any change in address.
 
Verification of License to Another State - Submit a $15.00 personal check or money order payable to "Commonwealth of PA" for each verification, along with a written request that includes the licensee's name, Pennsylvania license number and where the verification is to be sent.
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Board application forms available to be downloaded:

PHYSICIAN AND SURGEON (MD)
 
 
PHYSICIAN ASSISTANT (PAC)
 
NURSE-MIDWIFE (CNM)
 
RESPIRATORY THERAPIST (RT)
 
ATHLETIC TRAINER (ATC)
 
 
ACUPUNCTURIST (AK) and/or PRACTITIONER OF ORIENTAL MEDICINE (POM)
 
PERFUSIONIST
 
  
BEHAVIOR SPECIALIST
 
  
 
 
REACTIVATION/STATUS CHANGE APPLICATIONS
 
 
ALL OTHER APPLICATIONS/FORMS
 

Questions regarding practice of this profession may be directed to the Office of the State Board:
Board Administrator, State Board of Medicine, P.O. Box 2649, Harrisburg, PA  17105-2649, (717) 783-1400.  e-mail:  ST-MEDICINE@pa.gov
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Board Examination Information:
 
MEDICAL DOCTORS
 
USMLE Step 3 
For examination information contact the:  Federation of State Medical Boards of the United States, Inc., (FSMB), 400 Fuller Wiser Road, Euless, TX  76039.  Phone:  817-571-2949.
 
PHYSICIAN ASSISTANTS
 
NCCPA Examination 
For examination information contact:  National Commission on Certification of Physician Assistants (NCCPA), 12000 Findley Road, Suite 200, Duluth, GA  30097.  Phone 678-417-8100; FAX 678-417-8135. 
 
NURSE-MIDWIVES
 
ACNM Certification Examination 
For examination information contact:  American Midwifery Certification Board, Inc.  849 International Drive, Suite 205, Linthicum, MD  21090.  Phone number 410-694-9424; Fax number 410-694-9425.
 
ACUPUNCTURISTS
 
NCCAOM Certification Examination 
For examination information contact:  National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), 11 Canal Center Plaza, Suite 300, Alexandria, VA  22314.  Phone 703-548-9004; FAX 703-548-9097. 
 
RESPIRATORY THERAPISTS
 
NBRC Certification Examination 
For examination application information (if a graduate of a therapist or technician program) contact:  National Board for Respiratory Care (NBRC), 8310 Nieman Road, Lenexa, KS  66214-1579.  Phone 913-599-4200; FAX 913-541-0156; E-mail address: NBRC.     For examination application information (if not a graduate of a therapist or technician program) contact the Board office. Completed applications are submitted directly to NBRC.
  
 
RADIOLOGY EXAMINATION (FOR AUXILIARY PERSONNEL PERFORMING RADIOLOGIC PROCEDURE)
 
Completed applications are submitted directly to the State Board of Medicine, P.O. Box 2649, Harrisburg, PA  17105-2649, FAX 717-787-7769. Fees subject to change.
 
Examinations are administered as computer based tests (CBT) through the Pearson VUE.
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RENEWAL DATES & FEES:
 
Medical Doctor-Unrestricted December 31 - Even-Numbered Years $360.00
Medical Doctor-Training Yearly (Dates vary) $15.00
Medical Doctor-Institutional December 31 - Even-Numbered Years $25.00
Physician Assistant December 31 - Even-Numbered Years $40.00
Nurse-Midwife December 31 - Even-Numbered Years
$40.00
Nurse-Midwife Prescriptive Authority December 31 - Even-Numbered Years $25.00
Acupuncturist December 31 - Even-Numbered Years $40.00
Practitioner of Oriental Medicine December 31 - Even-Numbered Years
$40.00
Athletic Trainer      
December 31 - Even-Numbered Years 
   $37.00
Perfusionist  December 31 - Even-Numbered Years $50.00 
Respiratory Therapist December 31 - Even-Numbered Years $25.00
 
 
NOTE:  The Post Office does not forward licenses.
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State Board of Medicine
P.O. Box 2649, Harrisburg, PA 17105-2649
Phone - (717) 783-1400
Fax - (717) 787-7769
RA-MEDICINE@pa.gov


Modified Date: 07/30/2012 11:17 AM
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