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Address and Name Change Information
Address Change
You are required to notify the Indiana Professional Licensing Agency of any address change. You may log into your account at MyLicense.IN.gov and update your mailing address. Or, you may contact us via phone at (317) 234-8800, via email at pla14@pla.in.gov, or via fax at (317) 233-4236 to report a change of address. You can also submit your address change in writing to:
Indiana Professional Licensing Agency
Attn:State Board of Massage Therapy
402 West Washington Street, Room W072
Indianapolis, Indiana 46204
Please include your name, license number or social security number, and both your old and new addresses on any written correspondence.
Name Change
You may have the name changed on your licensure records by submitting a legal name change document (marriage certificate, divorce decree, social security card or other legal name change documents) by logging into your account at MyLicense.IN.gov and selecting "License Update" from the left menu. Or you may submit name change requests and documentation to:
Indiana Professional Licensing Agency
Attn:State Board of Massage Therapy
402 West Washington Street, Room W072
Indianapolis, Indiana 46204
Please include your name as it is listed now, your new name, and your license number or social security number on all correspondence.
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