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KEEP A COPY OF THIS APPLICATION FOR YOUR RECORDS. (Version 072015) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS HEALTH LICENSING DIVISION STATE
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Reactivation application PDF-PA is a form used to request the reactivation of a specific account or license.
Individuals or businesses who wish to reactivate their account or license are required to file the reactivation application PDF-PA.
The reactivation application PDF-PA should be filled out completely and accurately, providing all requested information and any supporting documentation that may be required.
The purpose of reactivation application PDF-PA is to formally request the reactivation of an account or license that has been inactive or expired.
Information such as account or license number, reason for inactivity, and any updates or changes to contact information must be reported on the reactivation application PDF-PA.
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