Get the free Request for Duplicate License - Maryland Department of Health

Maryland Board of Chiropractic Examiners 4201 Patterson Ave., Suite 301 Baltimore, MD 21215 (410)7644726 www.dhmh.maryland.gov/chiropracticREQUEST FOR DUPLICATE LICENSE Please type or print all information. This

How to fill out request for duplicate license

How to fill out request for duplicate license

1. To fill out a request for a duplicate license, follow these steps:
2. Obtain the relevant request form from the appropriate licensing authority.
3. Fill out the personal information section, including your full name, address, contact number, and any other required details.
4. Indicate the reason for requesting a duplicate license. This can be due to loss, theft, damage, or other valid reasons.
5. Provide the details of the original license, such as the license number, issue date, and expiration date.
6. If applicable, include any supporting documents or evidence, such as a police report or affidavit of loss.
7. Sign and date the request form.
8. Submit the completed request form along with any required fees or supporting documents to the licensing authority.
9. Wait for the processing of your request. The time it takes to receive the duplicate license may vary depending on the licensing authority's procedures.

Who needs request for duplicate license?

1. Anyone who has lost, had their license stolen, or damaged their license may need to request a duplicate license.
2. It is also necessary for individuals who have legally changed their name and need a license with the updated information.
3. Furthermore, those whose license has expired and need a new one can also submit a request for a duplicate license.

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What is request for duplicate license?

A request for duplicate license is a formal submission to obtain a replacement license when the original license has been lost, stolen, or damaged.

Who is required to file request for duplicate license?

Anyone who has lost, stolen, or damaged their original license is required to file a request for duplicate license.

How to fill out request for duplicate license?

To fill out a request for duplicate license, one must provide personal information, details of the lost/stolen/damaged license, and any necessary documentation.

What is the purpose of request for duplicate license?

The purpose of a request for duplicate license is to obtain a replacement for a lost, stolen, or damaged license.

What information must be reported on request for duplicate license?

Information such as name, address, license number, and details of the lost/stolen/damaged license must be reported on a request for duplicate license.