Applications for Licensure
LICENSED IN ILLINOIS – PLEASE READ THIS IMMEDIATELY
We have been informed by the State of Illinois that it could possible take months to receive license verifications from their Medical Board due to staffing cuts.
If you are licensed in Illinois we highly suggest that you send for your license verification prior to applying for licensure with Indiana.
The Indiana Medical Board will look at putting some type of procedures in place regarding the Illinois verifications should it become problematic.
- 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
