Athletic Trainer (AT)

The following fees shall be collected by the Board:

1. Application for license: $80.00
2. Annual renewal of license:
   1. Form renewal: $70.00
   2. On-line renewal: $67.00
3. Late renewal:
   1. Form late renewal: +$5.00
   2. On-line late renewal: +$5.00
4. License reinstatement: $10.00
5. Certified copy of license: $15.00
6. Temporary permit: $25.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00

Contact Lens Distributor

The following fees shall be collected by the Board:

1. Application for registration: $150.00
2. Annual renewal: $150.00

Corporate Practice of Medicine

The following fees shall be collected by the Board:

1. Application for business entity certificate of authorization: $1,000.00
2. Annual renewal of business entity certificate of authorization: $1,000.00

The following fees shall be collected by the Board:

1. Application for active or federal active license $300.00
2. Application for exempt or inactive license $150.00
3. Application for resident active license $100.00
4. Application for reentry active license $300.00
5. Annual renewal of active or federally active license:
   1. Paper renewal $430.00
   2. On-line renewal $360.00
6. Annual renewal of inactive license:
   1. Paper renewal $150.00
   2. On-line renewal $150.00
7. Annual renewal of exempt license:
   1. Paper renewal $150.00
   2. On-line renewal $150.00
8. Annual renewal of resident active license $100.00
9. Annual renewal of reentry active license $300.00
10. Conversion from inactive to active license $175.00
11. Conversion from exempt to active license $175.00
12. Additional fee for late renewal of active or federally active license:
    1. Paper late renewal +$230.00
    2. On-line late renewal +$100.00
13. Additional fee for late renewal of inactive license:
    1. Paper late renewal +$80.00
    2. On-line late renewal +$55.00
14. Additional fee for late renewal of exempt license:
    1. Paper late renewal +$80.00
    2. On-line late renewal +$55.00
15. Institutional license $230.00
16. Biennial renewal of institutional license $200.00
17. Visiting clinical professor license $150.00
18. Annual renewal of visiting clinical professor license $115.00
19. Limited permit $30.00
20. Annual renewal of limited permit $15.00
21. Reinstatement of cancelled limited permit $15.00
22. Visiting professor temporary license $25.00
23. Postgraduate training permit $50.00
24. Reinstatement of cancelled license $400.00
25. Reinstatement of revoked license $1000.00
26. Temporary permit $50.00
27. Special permit $30.00
28. Certified statement of license $15.00
29. Copy of wall license $15.00
30. Written verification of license or permit $25.00

Other Fees:

1. Criminal Background Check $57.00
2. National Practitioner Data Bank ("NPDB") $3.00

Independent Certified Nurse Midwife (CNM-I)

The Board shall charge and collect, in advance, fees for certified nurse-midwives, as established by the board, not to exceed:

1. Application for license: $100.00
2. Annual renewal of license:
   1. Form renewal: $75.00
   2. On-line renewal: $50.00
3. Late renewal:
   1. Form late renewal: +$50.00
   2. On-line renewal: +$25.00
4. License Reinstatement: $100.00
5. Certified copy of license: $20.00
6. Verified copy of license: $20.00

Other Fees:

1. Criminal Background Check $57.00
2. National Practitioner Data Bank ("NPDB") $3.00

Licensed Acupuncturist (L.Ac.)

The following fees shall be collected by the Board:

1. Application for license: $165.00
2. Annual renewal of active license:
   1. Form renewal: $150.00
   2. On-line renewal: $125.00
3. Annual renewal of inactive license:
   1. Form renewal: $125.00
   2. On-line renewal: $100.00
4. Annual renewal of exempt license:
   1. Form renewal: $125.00
   2. On-line renewal: $100.00
5. Conversion from inactive to active license: $75.00
6. Conversion from exempt to active license: $75.00
7. Late renewal:
   1. Form renewal: +$50.00
   2. On-line renewal: +$25.00
8. Application for reinstatement of canceled license: $165.00
9. Application for reinstatement of revoked license: $500.00
10. Certified copy of license: $20.00
11. Written verification of license: $20.00

If a licensed acupuncturist’s initial licensure period is six months or less before the first annual renewal period, the first annual renewal fee shall be prorated at $10.00 per month for any full or partial month.

Naturopathic Doctor (ND)

The following fees shall be collected by the Board:

1. Application for registration: $165.00
2. Registration renewal: $125.00
3. Registration late renewal additional fee: $20.00
4. Registration reinstatement: $155.00
5. Certified copy of registration: $15.00
6. Temporary registration: $30.00
7. Acupuncture certification: $20.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00

Occupational Therapy (OT, OTA)

The following fees shall be collected by the Board:

1. Application for license: $80.00
2. License renewal:
   1. Form renewal: $75.00
   2. On-line renewal: $72.00
3. License late renewal:
   1. Form late renewal: $80.00
   2. On-line late renewal: $77.00
4. License reinstatement: $80.00
5. Certified copy of license: $15.00
6. Temporary license: $25.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00

Physical Therapy (PT, PTA)

The following fees shall be collected by the Board:

1. Application based upon certificate of prior examination: $80.00
2. Application based on examination: $80.00
3. Annual renewal:
   1. Form renewal: $70.00
   2. On-line renewal: $67.00
4. Late renewal:
   1. Form late renewal: +$5.00
   2. On-line late renewal: +$5.00
5. Reinstatement: $80.00
6. Certified copy: $15.00
7. Duplicate certificate: $15.00
8. Temporary permit: $25.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00

Physician Assistant (PA)

The following fees shall be collected by the Board:

1. Application for license: $200.00
2. Annual renewal of license:
   1. Form renewal: $150.00
   2. On-line renewal: $150.00
3. Late renewal of license:
   1. Form late renewal: $215.00
   2. On-line late renewal: $208.00
4. License reinstatement: $250.00
5. Copy of license certificate: $15.00
6. Certified statement of licensure: $15.00
7. Temporary permit: $30.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00

Podiatry (DPM)

The following fees shall be collected by the Board:

1. Application for license: $300.00
2. Examination: $450.00
3. Annual renewal of active or federally active license:
   1. Form renewal: $330.00
   2. On-line renewal: $320.00
4. Annual renewal of inactive license:
   1. Form renewal: $150.00
   2. On-line renewal: $150.00
5. Annual renewal of exempt license:
   1. Form renewal: $150.00
   2. On-line renewal: $150.00
6. Conversion from exempt to active license: $175.00
7. Conversion from inactive to active license: $175.00
8. Late renewal of active or federally active license:
   1. Form late renewal: $350.00
   2. On-line late renewal: $339.00
9. Late renewal of inactive license:
   1. Form late renewal: $175.00
   2. On-line late renewal: $165.00
10. Late renewal of exempt license:
    1. Form late renewal: $175.00
    2. On-line late renewal: $165.00
11. Temporary license: $50.00
12. Duplicate license: $15.00
13. Temporary permit: $50.00
14. Certified statement of license: $15.00
15. Postgraduate permit: $50.00
16. Reinstatement of revoked license: $1000.00
17. Reinstatement of canceled license: $300.00
18. Special permit: $30.00
19. Written verification of license or permit: $25.00

Other Fees:

1. Criminal Background Check $57.00
2. National Practitioner Data Bank ("NPDB") $3.00

Radiologic Technologist (LRT)

The following fees shall be collected by the Board:

1. Application for license: $60.00
2. Annual renewal of license:
   1. Form renewal: $50.00
   2. On-line renewal: $45.00
3. Late renewal of license:
   1. Form late renewal: $55.00
   2. On-line late renewal: $50.00
4. Reinstatement of cancelled license: $60.00
5. Certified copy of license: $15.00
6. Temporary license: $25.00
7. Reinstatement of revoked license: $100.00

Respiratory Therapy (RT)

The following fees shall be collected by the Board:

1. Application for a license: $80.00
2. License renewal:
   1. Form renewal: $75.00
   2. On-line renewal: $72.00
3. License late renewal:
   1. Form late renewal: $80.00
   2. On-line late renewal: $77.00
4. License reinstatement: $80.00
5. Certified copy of license: $15.00
6. Special permit: $15.00
7. Temporary license: $25.00

Other Fees:

1. National Practitioner Data Bank ("NPDB") $3.00