Limited Temporary Permits
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Go to MyLicense.IN.gov and you will either need to create or login to your Access Indiana, single sign-on account. You will complete the online application and submit payment with a credit or debit card. Please allow 48 business hours for your application to be received and reviewed. You will be contacted by a customer service representative with details of what additional documentation is required to complete your application.
Basis for Limited Temporary Permit: A limited temporary permit issued under this section shall be limited to a specific activity, function, series of events, or purpose and to a specific geographical area within the state, which limitations shall be stated on the face of the temporary permit.
Chiropractor Limited Temporary Permit Application Instructions
- Completed Application: Applications may be submitted online at MyLicense.IN.gov or completed by paper and mailed to our office.
- Application fee of $50.00: Pay by credit or debit card for applications submitted online at MyLicense.IN.gov. If applying by paper/mail make checks or money orders payable to Indiana Professional Licensing Agency. All application fees are nonrefundable.
- Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.
- Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
- Official Chiropractic Transcripts: Applicants must submit official chiropractic transcripts, sent directly to the board from the school, certifying receipt of a professional chiropractic degree.
- Verification of Licensure: Verification of any registration/license/certification to practice any health-related profession or occupation in another state or territory. Verifications must be submitted directly from the state of issuance. You may find the verification form here.
If a state examination was administered, please have the state board attach the examination subjects and scores to the verification of licensure form. The information must be sent by the state or province that issued the license.
The Fair Information Practice Act: In compliance with Ind. Code 4-1-6, this agency is notifying you that you must provide the requested information, or your application will not be processed. You have the right to challenge, correct, or explain information maintained by this agency. The information you provide will become public record. Your examination scores and grade transcripts are confidential except in circumstances where their release is required by law, in which case you will be notified.
Mandatory Disclosure of U.S. Social Security Number: Your social security number is being requested by this state agency in accordance with Ind. Code 4-1-8-1 and 25-1-5- 11(a). Disclosure is mandatory, and this record cannot be processed without it.
Failure to disclose your U.S. social security number will result in the denial of your application. Application fees are not refundable.
Abandon Applications: If an applicant does not submit all requirements within one (1) year after the date on which the application is filed, the application for licensure is abandoned without any action of the Board. An application submitted after an abandoned application shall be treated as a new application.
- IPLA Address/Phone Number/Fax/Email/Website: Indiana Professional Licensing Agency
Attn: Chiropractic Board
402 West Washington Street, Room W072
Indianapolis, Indiana 46204
Staff Phone: (317) 234-2054
FAX #: (317) 233-4236
Staff Email: firstname.lastname@example.org
- Transcripts & State Verifications Must Be Sent Directly from Each Entity: The Board will not be able to accept any transcripts or state verifications directly from the applicant. All transcripts and state verifications must be sent directly from those entities.
- Issuance of Limited Temporary Permit: Upon issuance of your limited temporary permit by the Board, you will be sent an email notifying you that your limited temporary permit has been issued. There will be instructions on how to purchase a blue license card to be mailed to you or how to download a free license card for immediate printing. This service will be available at www.in.gov/pla/license.htm.
- Temporary Permit Expiration: A temporary permit is valid for a nonrenewable period of not more than thirty (30) days and shall be limited to a specific activity, function, series of events, or purpose and to a specific geographical area within the state, which limitations shall be stated on the face of the temporary permit.