Request for Duplicate Renewal Application

To obtain a duplicate renewal application, please provide the Committee with the information requested below and click "Submit". In most cases, the renewal application will be sent out within 1-2 business days.

Note: If you do not know your license number, go to Online Services and click on Licensee Search. Leave the County Name and Profession Name fields set to ALL. Click on Licensee Name and type your name in the text box provided. Be sure to enter your name specifically as requested (i.e. 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 the license
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Request Type