Licensure Certification Form

Licensure Certification Form

If you are requesting certification of a state license, please complete and submit the online request form or you can print and mail your request and required fee for processing to:

Division of Medical Quality Assurance
Licensure Support Services
Attn: License Verifications
P.O. Box 6320
Tallahassee, FL 32314-6320

Important Information

  • Please use this form to request certification of your Florida license by mail.
  • Please allow 7 to 10 days for your request to be processed.
  • If you need to verify a license that you hold in another state, please contact your state board.
  • If you are applying for a Florida license, you do not need to submit a verification request for your Florida license.
  • If you are requesting that your exam scores be submitted with your request for certification, please complete and forward the attached Waiver of Confidentiality and Authorization to Release Scores Form with your request for certification. Please be aware that most states do not require exam scores, please check with the licensing authority prior to requesting this information.
  • Do Not Use This Form for License Renewal. If you are trying to renew your license, click here.

For EMTs, Paramedics, and Radiologic Technologists

There is no fee associated with Licensure Verification for your profession.
Complete the License Certification form and mail to:

Department of Health
Licensing Support Services
4052 Bald Cypress Way
Bin C-10
Tallahassee, Florida 32399-3260

For All Other Health Care Professions

You may request licensure certification online or in writing. Include a cashier's check or money order, payable to the Department of Health, in the amount of $25.00 for each certification requested.


Other Important Information

Requests for licensure certification received without the appropriate fee will not be processed and a new request with fee will be required to complete the process.

The Division of Medical Quality Assurance cannot guarantee your verification will meet the deadlines for other State Boards. The current processing time for licensure verifications is approximately 10 days from receipt. Please check your deadline dates before you submit your verification request.

Release forms from the licensees are not required for verifications.

Exemptions: Financial information, medical information, school transcripts, examination questions, answers, papers, grades and grading keys, are confidential and exempt forms pursuant to Chapter 119.071, Florida Statutes and will be withheld pursuant to Chapter 456.057, Florida Statutes. Social Security numbers will also be redacted pursuant to 42 U.S.C. 405(c)(2)(C) (vii)(1).

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