License Applications - Board of Medical Practice
The Board of Medical Practice licenses physicians and podiatrists and certifies physician assistants and anesthesiologist assistants. Information appears below about license and certification fees and applications.
Also appearing below is information about the Prescriber Data-Sharing Program.
*All documents are in pdf format
- For other application forms, please e-mail your request to: medicalboard@ahs.state.vt.us
Fees
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 assistants and anesthesiologist assistants, the intial and
renewal fee is $115.
For each additional site (adding a new employer, such as an additional
institution, clinic, or other agency), the fee is $50.
For verification of licenses and certifications, the fee for each
verification is $50.
For reprints of licenses, the fee for each reprint 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.