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This page, Limited License Renewal - Same Program, is offered by

Limited License Renewal - Same Program

Here are the forms, requirements, and next steps to renew a Limited License in the same 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 within the same 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 Renewal

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

Application Kit for Limited License Renewal (PDF 999.55 KB)

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.

    Additional Resources

    Limited Renewal Instructions (DOCX 49.05 KB)
    Limited Renewal Checklist (DOCX 46.94 KB)
    Limited Renewal Application (DOCX 48.48 KB)
    Supervisory Evaluation Form (DOCX 31.83 KB)
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