DPH: Reinstatement of a Lapsed License

Reinstatement of a Lapsed License

 

Before applying for licensure, please familiarize yourself with the general licensing policies.

An applicant for reinstatement of a Connecticut license that has lapsed due to nonrenewal shall provide the following documentation:

 

A completed, notarized application with photo and fee in the amount of $200.00 in the form of a bank check or money order payable to, “Treasurer, State of Connecticut”;

 

The applicant’s current curriculum vitae (CV) or synopsis of professional activity since completion of the applicant's educational program;

 

Verification of any out-of-state license held, current or expired submitted directly to this office from the source.  Please contact  the jurisdiction prior to submission of the form as some may charge a fee for this service;

 

Verification from the appropriate authority confirming your most recent employment; including dates and an overall evaluation of your ability to practice with reasonable skill and safety; and

 

Verification of completion of at least 10 hours of continuing education activites completed within the previous 1 year period from the date the application for reinstatement.

 

Note:  Typically, applicants for reinstatement who have not been in active, clinical practice for longer than five years are required to complete a period of refresher training.  Applicants to whom this applies will receive further information from the Department upon receipt of all required documentation.

 

All supporting documentation must be submitted from the source to:

 

Connecticut Department of Public Health

Audiologist Licensure

410 Capitol Ave., MS # 12 APP

P.O. Box 340308

Hartford, CT 06134

Phone:  (860) 509-7603

Fax:  (860) 707-1930

Email:  Dph.Hairdresserteam@ct.gov





Content Last Modified on 4/3/2012 9:39:57 AM