Duplicate license/ACSC annual certificate or wall certificate
Duplicate license/ACSC annual certificate - lost or destroyed
- For lost or destroyed annual license or ACSC receipt, please use the duplicate annual certificate request.
- Replacement annual receipts will be mailed to licensee's address of record.
- Duplicate license and ACSC certificates cannot be faxed.
- There is no charge for this service.
Duplicate wall certificate - lost or destroyed
- For lost or destroyed wall certificates, please use the replacement wall certificate form.
- There is a $25 fee for this service.
- A notarized affidavit as to how and when the license was lost or destroyed is required.
Duplicate license/ACSC annual certificate - name change
- First submit a name change application.
- Indicate whether you need duplicate license and/or ACSC annual certificates.
- A copy of the legal document verifying name change must be submitted.
- There is no charge for this service.
Duplicate wall certificate - name change
- First complete a name change application.
- Submit the replacement wall certificate request concurrently with the name change application.
- A notarized affidavit as to how and when the license was lost or destroyed is required.
- There is a $25 fee for a replacement wall certificate.
Copyright 2012 © The Alabama Board of Medical Examiners
All rights reserved
All rights reserved