Ariz. Admin. Code § R9-16-215 - Changes Affecting a License or a Licensee; Request for a Duplicate License

A. A licensee shall submit a notice to the Department in writing within 30 calendar days after the effective date of a change in:

1. The licensee's home address or e-mail address, including the new home address or e-mail address;

2. The licensee's name, including a copy of one of the following with the licensee's new name:

a. Marriage certificate,

b. Divorce decree, or

c. Other legal document establishing the licensee's new name; and

3. The place or places, including address or addresses, where the licensee engages in the practice of audiology, speech-language pathology, or fitting and dispensing hearing aids.

B. A licensee may obtain a duplicate license by submitting to the Department a written request for a duplicate license in a format provided by the Department that includes:

1. The licensee's name and address,

2. The licensee's license number and expiration date,

3. The licensee's signature and date of signature, and

4. A $25 duplicate license fee.

A. A licensee shall submit to the Department a notice in a Department-provided format within 30 calendar days after the effective date of a change in:

1. The licensee's home address or e-mail address, including the new home address or e-mail address;

2. The licensee's name, including a copy of one of the following with the licensee's new name:

a. Marriage certificate,

b. Divorce decree, or

c. Other legal document establishing the licensee's new name; and

3. The place or places, including address or addresses, where the licensee engages in the practice of audiology or speech-language pathology.

B. A licensee may obtain a duplicate license by submitting to the Department a written request for a duplicate license in a format provided by the Department that includes:

1. The licensee's name and address,

2. The licensee's license number and expiration date,

3. The licensee's signature and date of signature, and

4. A duplicate license fee specified in R9-16-216.

Notes

Ariz. Admin. Code § R9-16-215

Amended by exempt rulemaking at 20 A.A.R. 1998, effective 7/1/2014. Amended by final expedited rulemaking at 26 A.A.R. 816, effective 4/8/2020.