a) An applicant for licensure as a licensed certified professional midwife who is licensed under the laws of another state shall file an application on forms provided by the Division. Applicants must be at least 21 years of age. The application shall include:

1. 1) A certification from the jurisdiction of original licensure and current licensure stating:

A) The date of issuance and status of the license; and

1. B) Whether the records of the applicant's current licensing authority contain any record of any disciplinary actions taken or pending.

2) Proof of the following:

1. A) Valid certified professional midwife certification granted by the North American Registry of Midwives;
2. B) Active cardiopulmonary resuscitation certification;

3. C) Active neonatal resuscitation provider status; and

   1. D) Certification of previous successful completion of an examination that is the same or similar to the examination as provided for in Section 1345.20. If the applicant does not meet this requirement, the applicant must successfully complete the examination provided for in Section 1345.20.

3) The fee required in Section 1345.55.

1. b) The Division shall examine each endorsement application to determine whether the requirements in the other state at the date of licensing were substantially equivalent to the requirements of the Act and this Part.