Ariz. Admin. Code § R4-38-109 - License Renewal
A. The
Board shall provide a licensee with at least 30 days' notice of the need to
renew the licensee's license. It is the responsibility of the licensee to renew
timely. Failure to receive notice of the need to renew does not excuse failure
to renew timely.
B. Under A.R.S.
§
32-2915(G), a licensee who wishes to continue practicing homeopathic medicine shall submit
the license renewal materials described in subsection (E) annually on or before
the last day of the month in which the license was initially issued.
C. A licensee who fails to comply with
subsection (E) by the date specified in subsection (B) may apply for license
renewal within 60 days after the date specified in subsection (B) by:
1. Submitting to the Board the license
renewal materials described in subsection (E), and
2. Paying the late renewal penalty prescribed
in
R4-38-106.
D. If a licensee fails to comply
with either subsection (B) or (C), the licensee's license expires and the
licensee shall immediately cease practicing homeopathic medicine. A licensee
whose license expires may obtain licensure only by complying again with
R4-38-108 and taking the examination specified in R4-38-107.
E. To renew a license issued by the Board, a
licensee shall submit the following directly to the Board:
1. A license renewal application that
contains the following information about the applicant:
a. Name;
b. License number;
c. Business name and address;
d. Residential address;
e. Business telephone number;
f. E-mail address;
g. Address and telephone numbers of each
location at which the licensee practices;
h. Number of the active M.D. or D.O. license
held by the licensee and name of the state that issued the license;
and
i. A statement indicating
whether during the last 12 months:
i. A
licensing authority of another jurisdiction denied the licensee a license to
practice allopathic, homeopathic, or osteopathic medicine and if so, the name
of the jurisdiction, date of the denial, and an explanation of the
circumstances;
ii. A licensing
authority of another jurisdiction revoked, suspended, limited, restricted, or
took other action regarding a license of the licensee and if so, the name of
the jurisdiction taking action, nature and date of the action taken, and an
explanation of the circumstances;
iii. The licensee has been convicted of or
pled guilty or nolo contendere to a criminal charge, including driving under
the influence of drugs or alcohol, and if so, the name of the jurisdiction in
which convicted, nature of the crime, date of conviction, and current
status;
iv. A lawsuit was filed or
settlement entered into or judgment entered against the licensee alleging
professional malpractice or negligence in the practice of homeopathic,
allopathic, or osteopathic medicine and if so, the case number, date of action,
the matters alleged, and whether the lawsuit is still pending or the manner in
which the settlement or judgment was resolved; and
v. The licensee has or had a mental illness
or psychological condition that may impair the licensee's ability to practice
homeopathic medicine safely and skillfully and if so, the nature of the
condition and any accommodations necessary;
vi. The licensee has been charged with or
arrested for any felony or misdemeanor involving conduct that may affect
patient safety or a felony as required under A.R.S. §
32-3208.
2. A list of the
treatment modalities the licensee makes available under the licensee's
supervision;
3. If the licensee
uses an experimental form of diagnosis or treatment in the licensee's practice
of medicine, a copy of the written informed consent materials that a patient
signs before examination or treatment;
4. A list of any specialty certifications
held by the licensee, the certifying entity, and the date the certification
expires;
5. If the licensee
dispenses drugs or devices as part of the licensee's practice of homeopathic
medicine:
a. The licensee's DEA registration
number;
b. A statement of whether a
complaint has been filed or legal action has been taken against the licensee by
a court or federal or state agency for dispensing a device, drug, or substance
and if so, the name and address of the court or federal or state agency and
documentation of the action taken; and
c. A list of the items dispensed;
6. An Arizona Statement of
Citizenship and documentary evidence of U.S. citizenship or qualified alien
status;
7. An affirmation that the
licensee has completed the continuing education required under A.R.S. §
32-2915;
8. An affirmation that the licensee is in
compliance with A.R.S. §
32-3211
regarding medical records;
9. The
license renewal fee prescribed under
R4-38-106; and
10. The licensee's dated signature affirming
that the information provided is true, correct, and complete.
Notes
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