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Reset Form INDIANA OPTOMETRY BOARD PROFESSIONAL LICENSING AGENCY 402 West Washington Street Room W072 Indianapolis IN 46204 Telephone 317 234-8800 E-mail pla14 pla.IN.gov www. Internal eye health evaluation other than direct ophthalmoscopy e.g. monocular indirect binocular indirect gonioscopy contact or non-contact fundus lens 4. Pla.IN.gov APPLICATION FOR OPTOMETRY LICENSE State Form 7 R15 / 10-16 Approved by State Board of Accounts 2016 INSTRUCTIONS 1. Binocular function e.g. cover test...
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