Name Change

If you have a facility name change, you must submit legal documentation verifying the change.  Please send the information to the Professional Licensing Agency at 402 West Washington Street, Room W072, Indianapolis, Indiana 46204, e-mail a copy to, or fax the information to (317) 233-4236.   If the name change is due to a change in ownership, you must submit a new licensing application and required documentation.

To receive an updated license with your changed name, please verify that the name change has been completed by our office at  Once it has been updated, you may request a duplicate license to be issued to you at the same website.  There is a $10 fee to receive a new license.

If you have any questions, you may contact the Board office at