(a) An applicant for a physician’s and surgeon’s license or a physician’s and surgeon’s licensee who is otherwise eligible for that license but is unable to practice some aspects of medicine safely due to a disability may receive a limited license if he or she does both of the following:

1. (1) Pays the appropriate initial or renewal license fee.
2. (2) Signs an agreement on a form prescribed by the board in which the applicant or licensee agrees to limit his or her practice in the manner prescribed by the reviewing physician and agreed to by the board.