| | |
| License Verifications | form |
| NPDB / HIPDB Report | if malpractice |
| Personal Interview | if issues |
|
Copy of ABMS Certificate
Copy of Legal Name Change Documents Copy of Initial Complaint and Final Order (or letter from lawyer if pending) for all malpractice cases ever named in.
If applying based on endorsement, verify active licenses.
CS Exam information is available online at http://dopl.utah.gov/licensing/physician_surgeon.html
FCVS REQUIRED |