Duplicate Renewal Application

Note: If you do not know your license number, go to the board's main web page and click on LICENSEE SEARCH on the sub navigation. Leave the County Name and Profession Name fields set to ALL. Click on Licensee or Practitioner DBA Name and type your name in the text box provided. Be sure to enter your name specifically as requested (ie, Doe, John). Click the SEARCH button. When your license record is found, click on DETAIL to obtain the license number.
Name as it appears on your certificate
License Type:
Funeral Director
Funeral Director Limited
Embalmers
Preneed Agent
Preneed Agent Funeral Director
Funeral Establishment
Preneed Provider
Preneed Seller
Signature: