Request a Certified Statement of Licensure from a Health Profession Board of Registration

You may need a certified statement of licensure from one of the health profession Boards of Registration to obtain licensure in another state.

Bureau of Health Professions Licensure

The Details of Request a Certified Statement of Licensure from a Health Profession Board of Registration

What you need for Request a Certified Statement of Licensure from a Health Profession Board of Registration

You can request a certified statement of licensure from the following Massachusetts Boards:

  • Board of Registration in Nursing 
  • Board of Registration in Pharmacy 
  • Board of Registration in Dentistry 
  • Board of Certification of Community Health Workers 
  • Board of Registration of Genetic Counselors 
  • Board of Registration in Naturopathy 
  • Board of Registration of Nursing Home Administrators 
  • Board of Registration of Perfusionists 
  • Board of Registration of Physician Assistants 
  • Board of Respiratory Care 

Fees for Request a Certified Statement of Licensure from a Health Profession Board of Registration

  • We accept checks or money orders made payable to the Commonwealth of Massachusetts
  • All fees are non-refundable and non-transferable
  • Please don't send cash
Name Fee Unit
Certified Statement of Licensure $15 per licensee
Handling charge for returned checks $23 each

How to request Request a Certified Statement of Licensure from a Health Profession Board of Registration

Certified Statement of Licensure from a Health Professions Board

  1. Submit a request, including:
    • Your name, profession, and license number
    • The address of where you would like the statement or form to be sent
    • Note: If you have a form from another state that needs to be completed, please include it with your request
  2. Include your fee payment, in the form of check or money order.
  3. Mail your request and check or money order addressed to the relevant Board to:
    239 Causeway St.
    Suite 500
    Boston, MA 02114

More info about Request a Certified Statement of Licensure from a Health Profession Board of Registration

Certified Statements

Learn how to request a Certified Statement of Licensure from the Drug Control Program.

Contact for Request a Certified Statement of Licensure from a Health Profession Board of Registration

Address
239 Causeway St., 5th Floor, Suite 500, Boston, MA 02114
Fax
(617) 973-0980

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