How to Request for an Address/Name Change/Duplicate License Request

Select form that is applicable for your license type and follow instructions contained in form.

 

**HEALTH CARE PROFESSIONALS
(**Physician, Osteopathic Physician, Physician Assistant, Podiatrist, Emergency Medical Technicians, Naturopathic Physician and Nurses)
ADDRESS/NAME CHANGE/DUPLICATE LICENSE REQUEST FORM

Application
Application Fillable Form

 

REAL ESTATE PROFESSIONALS
(Real Estate Broker, Real Estate Salesperson, Condominium Management Association, Condominium Hotel Operator)
ADDRESS/NAME CHANGE/DUPLICATE LICENSE REQUEST FORM

Application
Application Fillable Form

 

ALL OTHER LICENSE TYPES
ADDRESS/NAME CHANGE/DUPLICATE LICENSE REQUEST FORM

Application
Application Fillable Form