APPLICATIONS

The following applications are available online and may be printed, completed, and mailed to the Board offices. Please click on the links below for available applications. All applications may be reviewed and printed with Adobe Acrobat Reader 6.0 or higher.

MEDICAL DOCTORS

MD INITIAL LICENSE APPLICATION*
*This application is only for physicians who have never held a license previously in West Virginia.  If you have previously held a West Virginia license, you will need to contact the Board of Medicine for the correct, abbreviated, application form.

DRUG DISPENSING APPLICATION FORM

 

PHYSICIAN ASSISTANTS

PHYSICIAN ASSISTANT INITIAL LICENSE APPLICATION

PHYSICIAN ASSISTANT CHANGE OR ADDITION OF SUPERVISING PHYSICIAN(S) AND OR CHANGE OR ADDITION OF JOB LOCATION(S)

PRESCRIPTIVE WRITING PRIVILEGE APPLICATION

 

MEDICAL CORPORATIONS

MEDICAL CORPORATION APPLICATION FORM

MEDICAL CORPORATION RENEWAL FORM

 

P.L.L.C.'S

P.L.L.C. APPLICATION FORM

P.L.L.C. RENEWAL FORM