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- Laws and Regulations
- Address Change Form (DDS)
- Name Change Form (DDS)
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Name and Address Changes
Every dentist is required to register his/ her place(s) of practice with the Board on a form prescribed by the Board. B&P §§ 1650, 1651 Every dentist licensed in this state must also notify the Board if he/she has no place of practice. Any dentist who changes his/her place of practice must register with the Board within one month after the change.
In the event any licensee fails to notify the Board of a change of address within one month, the board may not renew his/her license until the penalty is paid. The penalty for late registration of change of place of practice is $50.00.
All places of practice must be registered with the Board. An additional office permit is required if a licensee has proprietary interest of any nature, or any right to participate in the management or control of more than one place of practice. B&P §1658.
Name ChangeA legal name change must be reported within 10 days. The requirements to complete a name change include:
- Form LIC-18 Notification of Name Change
- A copy of the legal document.
There is no fee for a name change unless a replacement pocket or wall license is requested. Once the name is changed, the next pocket license will automatically be issued be in the new name.
FeesThe fee to replace a pocket license is $50, unless the name change coincides with license renewal.
The fee to replace a wall license is $50 and requires the return of the original wall license.