Medical Board License Renewal Forms

To renew your Medical license by paper you must select a form below.  Print and mail the completed form with the required renewal fee to the Indiana Professional Licensing Agency.  The address is on the form and checks should be made out to 'Indiana Professional Licensing Agency'.  If you answer 'yes' to any of the questions be sure to include a detailed response with your renewal form.   

MD/DO Expired Renewal Form

MD/DO Reinstatement Renewal Form (Expired over 3 years)

CSR Expired Renewal Form

MD/DO Inactive Expired Renewal Form 

Medical Residency Permit Expired Renewal Form

Medical Fellowship Permit Expired Renewal Form