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Limited License Renewal - Change of Program

Here are the forms, requirements, and next steps to renew a Limited License in a different training program.

A limited license is issued to physicians enrolled in post-graduate training programs in health care facilities.  This information applies only to renewals with a change of training program

Fee for Renewal of a Limited License:  $100.00

For a description of license requirements and fees, see Licensing Fees and General Information.

Application Kit for Limited License Change of Program

Applicants should download or print the Application Kit—it contains all the necessary documents.

  • Do not send these forms to the Board of Registration in Medicine. All completed forms must be sent to your training program.
  • Do not complete and mail these forms until you have been accepted into an accredited training program.
  • The kit has a set of instructions. Please read the instructions carefully before filling out the forms.

Additional Resources for

Application Documents

The application documents are also available in Word format.  IF YOU CHOOSE NOT TO USE THE KIT, THEN YOU SHOULD DOWNLOAD OR PRINT THE DOCUMENTS BELOW.  ALL RELEVANT FORMS MUST BE SUBMITTED.

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