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 optician training/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; and

 

Verification from the appropriate authority confirming the applicant's most recent employment as an optician; including dates and overall evaluation of the applicant's ability to practice with reasonable skill and safety.

 

Note: Applicants for reinstatement who have not been in active practice as an optician for longer than six months are referred to the Connecticut Board of Examiners for Opticians for review.  Applicants to whom this applies will receive further information from the Department upon receipt of all required documentation.

 

Please arrange for all supporting documentation to be sent directly from the source to:

 

Connecticut Department of Public Health

Optician Licensure

410 Capitol Ave., MS #12 APP

P.O. Box 340308

Hartford, CT 06134

Phone: (860) 509-7603

Fax:  (860) 707-1929

Email:  dph.dentalteam@ct.gov





Content Last Modified on 4/3/2012 9:23:56 AM