Medical License Renewal Form Printable Illinois Chicago Office 555 West Monroe Street 5th Floor Chicago IL 60661 Springfield Office 320 West Washington Street 3rd Floor Springfield IL 62786 Call Us 1 888 473 4858
Chicago Office 555 West Monroe Street 5th Floor Chicago IL 60661 Springfield Office 320 West Washington Street 3rd Floor Springfield IL 62786 Call Us 1 888 473 4858 Chicago Office 555 West Monroe Street 5th Floor Chicago IL 60661 Springfield Office 320 West Washington Street 3rd Floor Springfield IL 62786 Call Us 1 888 473 4858
Medical License Renewal Form Printable Illinois
Medical License Renewal Form Printable Illinois
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LICENSE RENEWAL QUESTIONS You must respond to ALL the following questions to reinstate your license Failure to answer ALL these questions will result in the form s being returned to you for proper completion Since July 31 2017 do you now have any disease or condition that impairs or impaired your ability to perform the essential functions You have any medical or mental condition that may result in a loss of consciousness or any loss of ability to safely drive a vehicle or You take any medications that may impair your ability to drive Each time you renew your driver s license you must resubmit a Medical Report Form By law you must notify the Secretary of State s office
As part of ongoing efforts to provide a more efficient and responsive regulatory experience the Illinois Department of Financial and Professional Regulation IDFPR is implementing a new electronic initial licensure license renewal and license reprint process By moving away from a paper based license process IDFPR will save valuable Renew your Illinois professional license on IDFPR s Online Licensure Renewal page Print a copy of your Illinois professional license or submit a change of address ILCC Bartender License View additional information on the Beverage Alcohol Sellers and Servers Education and Training BASSET Footer
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CCA Form if applicable Verification of the requirements are available on our website www idfpr illinois gov SEND ALL REQUIRED INFORMATION AND PAYMENT TO ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION DIVISION OF PROFESSIONAL REGULATION POST OFFICE BOX 7450 SPRINGFIELD IL 62791 7450 Request for Reinstatement of Illinois The Illinois Department of Financial and Professional Regulation s mission is To protect the residents of Illinois To ensure the safety and soundness of financial institutions To ensure that competent professionals are licensed to provide services to the public and To enhance commerce in the state for the benefit of all its residents
Supervisor 245 20 for Home Health Agency Administrator and 245 30 g for Home Services and Home Nursing Agency Manager In order to report a change in management personnel please complete the Agency Manager Qualification Review Formand mail the form to our office This form must be mailed and cannot be faxed or emailed Illinois Medical Board License Renewal Physicians physician assistants and nurses are required to renew their licenses every three years with the Medical Board To renew your license you can do so online through the Department of Financial and Professional Regulation website Physicians pay 700 physician assistants pay 150 and nurses
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Chicago Office 555 West Monroe Street 5th Floor Chicago IL 60661 Springfield Office 320 West Washington Street 3rd Floor Springfield IL 62786 Call Us 1 888 473 4858
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Chicago Office 555 West Monroe Street 5th Floor Chicago IL 60661 Springfield Office 320 West Washington Street 3rd Floor Springfield IL 62786 Call Us 1 888 473 4858
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Medical License Renewal Form Printable Illinois - Renew your Illinois professional license on IDFPR s Online Licensure Renewal page Print a copy of your Illinois professional license or submit a change of address ILCC Bartender License View additional information on the Beverage Alcohol Sellers and Servers Education and Training BASSET Footer