Reactivation Physician License Application

The Reactivation Application is to be used by Physicians who previously held a Wyoming medical license but allowed the license to expire due to non-renewal of the license.

This application must be printed and mailed to the Board office, it cannot be submitted or paid for online.

Please print both the Instructions for Reactivating a Lapsed License as well as the Application for Reactivating a Lapsed License. Carefully read and follow all instructions. Contact the Board if you have any questions.