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2012 Indiana Physician Re-Licensure Survey Report Produced by: The Indiana Center for Health Workforce Studies Bowen Research Center, Department of Family Medicine Indiana University School of Medicine

How to fill out 2012 indiana physician re-licensure

How to Fill Out 2012 Indiana Physician Re-Licensure:

1. Start by gathering all the necessary documents and information required for the re-licensure application. This may include your current license, identification proof, educational credentials, and continuing education certificates.
2. Access the Indiana Medical Licensing Board's website or contact them to obtain the official application form for physician re-licensure. Make sure to use the correct form for the year 2012.
3. Carefully read through the instructions provided with the application form. It is crucial to understand the requirements and ensure you meet all the criteria for re-licensure.
4. Begin filling out the application form, entering your personal details such as name, contact information, and social security number. Double-check all the information for accuracy.
5. Provide details of your medical education, including the name of the medical school attended, dates of attendance, and degree obtained. Include any postgraduate training or residency programs you have completed.
6. Document your current employment status, including the name and address of any medical facility where you are currently practicing or associated with.
7. Disclose any disciplinary actions or criminal convictions, if applicable. It's important to be transparent and provide all the necessary information requested in this section.
8. Submit details of your continuing medical education (CME) credits earned during the re-licensure period. Include the type of activity, provider, date, and number of credits obtained. Ensure that you have met the required number of CME credits for re-licensure.
9. Provide the required documentation and certificates as proof of your continuing education credits. This may include attendance certificates, receipts, or transcripts.
10. Review your application thoroughly to ensure accuracy and completion. Attach any supporting documents as specified in the instructions, such as a copy of your current license.
11. Finally, submit your completed application, along with the required fees, to the Indiana Medical Licensing Board by the specified deadline. Keep a copy of your application and any supporting documents for your records.

Who Needs 2012 Indiana Physician Re-Licensure:

Physicians who currently hold or held a medical license in the state of Indiana in the year 2012 will need to go through the re-licensure process to maintain their license. This requirement ensures the continuing competence and adherence to the standards of medical practice in the state. Failure to complete the re-licensure process within the specified timeframe might result in the suspension or revocation of the physician's license. Therefore, it is essential for eligible physicians to complete the 2012 Indiana physician re-licensure to continue practicing medicine legally in the state.

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What is indiana physician re-licensure survey?

The Indiana physician re-licensure survey is a form that physicians in Indiana must complete to renew their medical licenses.

Who is required to file indiana physician re-licensure survey?

All physicians practicing in Indiana are required to file the physician re-licensure survey.

How to fill out indiana physician re-licensure survey?

Physicians can fill out the survey online through the Indiana Professional Licensing Agency website.

What is the purpose of indiana physician re-licensure survey?

The purpose of the survey is to ensure that physicians are meeting the requirements for license renewal and to gather information on their practice.

What information must be reported on indiana physician re-licensure survey?

Physicians must report information such as their current practice, any disciplinary actions, and continuing education credits.