License Applications - Board of Medical Practice
*All documents in pdf format
- For other application forms, please e-mail your request to: medicalboard@vdh.state.vt.us
Fees (Current and Future)
Important :
Current Fees
For physicians, the initial and reinstatement application fee is $625.
The renewal application fee is $500.
For podiatrists, the initial and reinstatement application fee $625.
The renewal application fee is $500.
For limited temporary licensure, the intial and renewal fee is $70.
For physician and anesthesiologist assistants, the intial and renewal fee
is $115.
For secondary sites the fee is $50.
For both verification of licenses and certifications the verification fee
is $50.
For reprints of license, the fee is $20.
If you have any questions, please do not hesitate to call the office at
(802) 657-4220.
Physician
- Initial License Application for Physicians
- Initial Application for Limited Temporary Physician License
Podiatrist
Physician Assistant
Anesthesiologist Assistant
Prescriber Data-Sharing Program
18 VSA Section 4631 (c)(1) requires the Department of Health and the Office of Professional Regulation (OPR), in consultation with the appropriate licensing boards, to establish a prescriber data-sharing program to allow a prescriber to give consent for his or her identifying information to be used for the purposes described at 18 VSA Section 4631 (d). 18 VSA Section 4631 (c)(2) further requires the Health Department or OPR to make available the list of prescribers who have consented to sharing their information. The list of prescribers provided at this website includes the list provided by OPR to the Health Department.