Limited License for Postgraduate Training Programs (Residency Permit)

Application for a Limited License to Participate in a Postgraduate Training Program for Podiatric Medicine

Attention Applicants Enrolled in 12 + Month Residency Programs
The Board is now allowing applicants to apply for licensure after the successful completion of a minimum of 12-months of a CPME approved residency program with a letter from your residency director stating that you have successfully completed 12 months of the residency and that you are continuing in the program.

Requirements for Limited License

Completed Application - Mail completed application along with all required documentation to the Indiana Professional Licensing Agency.

Affidavit - If you answer "yes" to any of the questions on page 2 of your application, you must explain fully in a signed and notarized statement, including all related details. Include the violation, location, date and disposition. If malpractice, provide name(s) of plaintiff(s). Letters from attorneys or insurance companies are not accepted in lieu of your statement.

Application Fee - A fifty dollar ($50) application fee made payable to the Indiana Professional Licensing Agency. This fee may be submitted by cash, check or money order. We cannot accept payment by credit card.

Photograph - One (1) passport-type photograph taken within the last eight (8) weeks.

Proof of Graduation - You may submit proof of graduation by submitting one (1) of the following documents:

  • Certificate of Completion - A statement verifying the date that the applicant has completed and will receive his/her diploma will be accepted under the signature and seal of the dean of the school or program.
  • Official Transcript - An official transcript of grades from the school from with you obtained your podiatric degree, which shows that all requirements for graduation have been met by the applicant; or
  • Degree - A notarized copy of your podiatric degree.

Postgraduate Training Form - This form is to be completed by the hospital/Institution Chairperson/Department Head and returned to the Indiana Professional Licensing Agency with the applicant's completed application.

Name Change - An official affidavit indicating any legal name change or notarized copy of a marriage certificate is acceptable, if you name differs from that on any of your documents.