Applications for Licensure

                    

• Instructions and Application for MD/DO License
• Instructions and Application for a Residency Permit
• Instructions and Application for a Teaching Permit
• Instructions and Application for a Fellowship Permit
• Instructions and Application for Non-Renewable Limited Scope Temp Med Permit
• Application and Instructions for a Controlled Substance Registration (CSR)
• State Verification Form
• Criminal Background Check Information
• Instructions and Application for Registering Under the Professional Corporation Act

         If you have previously held a license in Indiana please contact our office for instructions on what you need to do to activate that license.  Email pla3@pla.in.gov  phone (317) 234-2060