Acupuncture Licensure for Licensed Chiropractor/Dentist/Podiatrist Information

PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING AND SUBMITTING YOUR APPLICATION.

If after reading the instructions you have questions, please contact our office

CONTACT INFORMATION
Indiana Professional Licensing Agency
Medical Licensing Board
402 W. Washington Street, Room W072
Indianapolis, IN 46204
Email: pla3@pla.IN.gov
(317) 234-2060
(317) 233-4236 (fax)

1. Completed Application - Applications may be submitted online at MyLicense.IN.gov or completed by paper and mailed to our office.
   
   If you have ever held a license previously in Indiana, and are applying again for the same license type, please contact our office at (317) 234-2060 or by email at pla3@pla.in.gov< to inquire about reactivating your previous license.
    
2. Application Fee of $150.00 - Pay by credit or debit card for applications submitted online at MyLicense.IN.gov. If applying by paper/mail make checks or money orders payable to Indiana Professional Licensing Agency. All application fees are nonrefundable.
    
3. Criminal Background Check - If you submit a paper application, a confirmation email advising you to do your criminal background check will be sent to the email address supplied on the application. If the application is submitted online, you may start your criminal background check process after the receipt screen appears after submitting your online application and payment.
    
4. Positive Response Documentation - If the applicant has answered any of the questions on the application “yes” a written statement detailing the occurrence/situation, the outcome, date of occurrence must be submitted. If it is a malpractice payment, please include the amount paid. If applicable, please submit copies of all court documents and/or arrest records. Letters from attorneys or insurance companies are not accepted in lieu of a statement.
    
5. Verification of State Licensure(s) - The applicant must request a “License Verification or Letter of Good Standing” from each State/Country in which you currently are or have ever been licensed, certified, or registered in any regulated health profession or occupation. This includes all licenses etc., that are active, expired, inactive, retired, delinquent etc. In addition to any Acupuncture license/permit etc., this also pertains to any professional health license such as an EMT, Chiropractic, Dentist, Podiatrist, etc. The applicant will need to print off the verification form; contact the appropriate entities/States to see if they charge a fee for completing this form and send the form directly to them. They will in turn complete the verification and mail it directly to our office.
   
   The verification must come directly from the State or authority in which license was obtained.
    
6. Official Transcript/Certificate - The applicant must submit an official certificate or transcript from the school or program which is an approved college or university of learning accredited by an accrediting agency that has been approved by the United States Department of Education where the applicant obtained two hundred (200) hours of acupuncture training.
    

7. Proof of Licensure - Must submit proof of current licensure in Indiana as a chiropractor, a podiatrist, or a dentist.
    
8. Proof of Name Change - When the name on any document differs from the applicant’s name, a certified copy of a marriage certificate or legal name change must be submitted.
    

PROCESSING TIME - Processing time depends on the applicant. The applicant is responsible for the submission of all documents. If there is a positive response the license will not be issued until it has been reviewed by the Medical Licensing Board.

FAIR INFORMATION PRACTICE ACT - In compliance with IC 4-1-6, this agency is notifying all applicants that they must provide the requested information or the application will not be processed. The applicant has the right to challenge, correct, or explain information maintained by this agency. The information provided will become public record. Examination scores and grade transcripts are confidential except in circumstances where their release is required by law. A social security number is being requested by this state agency in accordance with IC 4-1-8-1. Disclosure is mandatory, and this record cannot be processed without it.

STATUTE AND RULES - Please view the statute and rules on our website as listed on the following link: https://www.in.gov/pla/3874.htm.