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Fee Schedule


NOTE: All fees are non-refundable.

PHYSICIAN FEES

Application and initial license fee [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), temporary license (if granted) pending completion and review of licensure application at next board meeting, and initial license (if granted) through the next June 30th]

$600.00 ($500.00 for persons holding a current T-2 license)

Paper form license application processing fee

$50.00

Annual renewal of license (including administrative license)

$240.00

Paper form renewal application processing fee

$25.00

License renewal grace period surcharge

$100.00

Reactivation of license [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), and license (if granted) through the next June 30th]

$400.00

Reinstatement of license [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), and license (if granted) through the next June 30th] [Costs may also be imposed under Ch. 4, §3(k)]

$400.00

Inactive license, conversion to (one-time fee)

$50.00

Inactive license renewal

No charge

First-year residency training license (“T-1” license)

$25.00

Second-year residency training license (“T-2” license)

$100.00

Residency training license (“T-2” license) renewal

$100.00

Volunteer license

$75.00

PHYSICIAN ASSISTANT FEES

Application for license 

$250.00

Application and license [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), temporary license (if granted) pending completion and review of licensure application at next board meeting, and initial license (if granted) through the next December 31st]

 

Annual renewal of license

$90.00

Paper form renewal application processing fee

$10.00

License renewal grace period surcharge  

$50.00

Replacement of lost license

$25.00

Reactivation of license  [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), and license (if granted) through the next December 31st]

$100.00

Reinstatement of license [Includes the cost of 1 NPDB report, 1 criminal record check (if necessary), and license (if granted) through the next December 31st] [Costs may also be imposed under Ch. 4, §3(k)]

$200.00

Extension of temporary license

$50.00

Volunteer license

$50.00

Emeritus license

No charge

GENERAL FEES

Verification of license

$35.00

Replacement of lost license – pocket size

$25.00

License – wall size

$50.00

Physician directory to non-licensees – per copy

$45.00

Physician mailing list

$500.00

Physician assistant mailing list

$100.00

Physician and physician assistant mailing lists

$550.00

Certified copies

First page: $10.00 Additional pages: $.50

Photocopies (except certified copies), including cost of duplication of transcript(s) and administrative record in appeals from contested case hearings [Ch. 4, §4(i)(xvi)]

First page: $2.00 Additional pages: $.10