Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 4. |
Subtitle 32. BOARD OF PHYSICIANS |
Chapter 10.32.01. General Licensure Regulations |
Sec. 10.32.01.16. Replacement Licenses
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A. The Board shall issue a replacement license or registration card if the original license is lost, destroyed, stolen, or damaged, or if there has been a change of the licensee's name.
B. The Board shall require that the following accompany requests for replacement licenses:
(1) The proper fee;
(2) Any required application forms which are to include the reason for the replacement license request;
(3) A passport quality photograph of the licensee, taken within 60 days of the application, affixed to the affidavit form supplied by the Board; and
(4) Return of the original license if the license is damaged or a replacement is sought for reasons of a name change.
C. If the request for a replacement license results from a change of name, the licensee shall submit a certified copy of the official document (marriage certificate, divorce decree, court order, or other document) indicating the name change, date, and place of change. If the change occurred during naturalization, the applicant shall also include the naturalization number, name and address of the court, and the date of naturalization, as well as the name change.
D. The Board shall issue a replacement license which bears the same number and expiration date as the original and shall print "Replacement" and the date of replacement across the front of the license.