Professional  Medical  Licensure in all  50 States
Renewal Services Order Form
$190 per license per renewal cycle
Will any of the Medical Licenses, DEA, or State CSR/CDS Drug Permits listed above expire within 90 days of today? If so list them below along with their expiration date: *
Have you been arrested since your last renewal? *
Have you been disciplined, placed on probation, or had employment or privileges restricted in any way since your last renewal? *
Since your last renewal have you ever had any notices from any Medical Board concerning your Medical License? This includes complaints, investigations, disciplinary actions, probation, suspensions, revocations, and etc. *
Since your last renewal have you been notified that a malpractice complaint was filed against you (no matter the final status)? *
Since your last renewal have any malpractice complaint resulted in a settlement, judgment, or dismissal? *
Since your last renewal have you been treated for substance abuse? *
Since your last renewal have you been treated for any Mental Illness (including depression) *
Since your last renewal have you been out of practice for more than 6 months? *
Since your last renewal has any negative action occurred which might need to be reported to a Medical Board? *
I understand that when I submit my order that my credit card will be charged $190 for each medical license, DEA number, State CSR/CDS permit which I list above. I authorize this charge. *
After you submit your order, you will receive an email from providing our welcome packet for new Renewal Clients within 24 hours. 
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