State Medical Board

Applications & Forms

Please click on the links under the categories below for available licensing forms. All forms may be viewed and printed with the free Adobe Acrobat Reader 6.0 or higher.

Initial Applications

 

Renewal Applications

Online renewal and renewal applications for the January 1, 2015 through December 31, 2016 licensing period will be available approximately 30 days before the December 31, 2014 expiration date of your license. Prior year renewal applications are not valid for other renewal years.

  • Medical License (MD/DO/DPM) renewal applications are not available at this time. If you need to reinstate a lapsed license, please contact the Division at (907) 465-2541 or 465-2550.
  • Mobile Intensive Care Paramedic License Renewal Application, #08-0078, Revised 09/18/12. Use this form to renew a license that lapsed on December 31, 2012. If you need to reinstate a license that lapsed earlier, please contact the Division at (907) 465-2541 or 465-2550
  • Physician Assistant License Renewal Application, #08-0079, Revised 09/18/12. Use this form to renew a license that lapsed on December 31, 2012. If you need to reinstate a license that lapsed earlier, please contact the Division at (907) 465-2541 or 465-2550

 

Miscellaneous Forms