12 AAC 28.954 - Temporary permit

(a) The board may issue a temporary permit to practice dentistry to a dentist who meets the requirements of this section for the purpose of substituting for a dentist the board has determined to be "incapacitated" as defined under AS 08.36.254.

(b) An applicant for a temporary permit under this section must submit to the department

(1) a complete, notarized application on a form provided by the department;

(2) the applicable fees in 12 AAC 02.190;

(3) a form completed by the incapacitated dentist or authorized representative of the incapacitated dentist providing information regarding the reason for the incapacitation and documentation of reasonable effort to find a substitute dentist licensed under this chapter;

(4) a form completed by the incapacitated dentist's healthcare provider verifying the dentist is incapacitated and unable to practice;

(5) verification of the applicants current license to practice dentistry from a board of dental examiners of a state or territory of the United State; the verification must include the applicants status and complete information regarding any disciplinary action or investigation taken or pending on behalf of the applicant;

(6) verification of the applicant's graduation from a dental school that at the time of graduation was accredited by the Commission on Dental Accreditation of the American Dental Association by submitting

(A) a certified true copy of the applicant's dental school diploma showing credentials similar or equivalent to the incapacitated dentist credentials; or

(B) transcripts sent directly from the issuing educational institution showing credentials similar or equivalent to the incapacitated dentist credentials;

(c) The department shall request a report from the National Practitioner Data Bank on behalf of the applicant. The board will review the report as a part of the application process and may deny a temporary permit application based on report content.

(d) An applicant for a temporary permit may not have had a license to practice dentistry revoked, suspended, or voluntarily surrendered in this state or another state or territory of the United States.

(e) The temporary permit issued will be authorized only for the practice locations of the incapacitated dentist. The name, license number, and practice locations of the incapacitated dentist will be printed on the license.

(f) The temporary permit will be extended past the initial 90 days if the applicant meets the requirements of AS 08.36.254(f) or (g) and pays the fee required in 12 AAC 02.190.

Notes

12 AAC 28.954

Eff. 1/1/2019,Register 229, April 2019

Authority:AS 08.36.070

AS 08.36.254