Contact for Request a Certified Statement of Licensure from a Health Profession Board of Registration
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
- 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
- Include your fee payment, in the form of check or money order.
- Mail your request and check or money order addressed to the relevant Board to:
250 Washington St.
Boston, MA 02108
Contact for Request a Certified Statement of Licensure from a Health Profession Board of Registration
Address
250 Washington St., Boston, MA 02108
Phone
Fax
(617) 973-0980