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SUPPORTING DOCUMENT IMPORTANT NOTICE: Completion of this form is necessary for consideration for licensure under 225 ILLS 446/1 ET. SEG. (Illinois Compiled Statutes). Disclosure of this information

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www.idfpr.com/dpr is the website where Illinois licensed professionals are required to file their license renewal application and disclosure of prior convictions or discipline.

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Licensed professionals in Illinois are required to file www.idfpr.com/dpr.

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The purpose of www.idfpr.com/dpr is to ensure that Illinois licensed professionals are in compliance with licensing laws and regulations.

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