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Other Physician License Applications

The following applications must mailed to the Board office, the application and applicable fees cannot be submitted or paid online. Please call or e-mail the Board to request the appropriate application be sent to you by mail or e-mail.

Reinstatement

A reinstatement application is to be submitted when a former licensee seeks to have a license that has been revoked or surrendered restored to active status.  In addition to submitting the reinstatement application, the former licensee must submit a petition seeking reinstatement



Administrative License

The board may issue an administrative medicine license to a physician who meets all qualifications for licensure in the state, including payment of a fee set by the board, but who does not intend to provide medical or clinical services to or for patients while in possession of an administrative medicine license and signs a notarized statement to that effect. An administrative medicine license is subject to annual renewal. 



Emeritus License

An emeritus license is available for physicians who hold a current Wyoming license to practice medicine and wish to provide clinical care in Wyoming without remuneration or for nominal remuneration in a non-profit facility.



Volunteer (Camp) License

A volunteer (camp) license may be issued to a physician who is in good standing in at least one jurisdiction other than the state of Wyoming for the purpose of providing medical treatment as a volunteer, without compensation. A volunteer (camp) license shall be valid for not more than twenty-one consecutive days in any calendar year, and may not be renewed.




Training (Residency) License

First year and second year training licenses are available to applicants currently enrolled in an A.C.G.M.E. or A.O.A. accredited residency program located in the state of Wyoming.


NOTICE

Please review the Board's Rules and Regulations to view the requirements of each individual license BEFORE you apply.