a) An applicant seeking registration in Illinois who is licensed/registered under the laws of another jurisdiction shall file an application with the Division, on forms provided by the Division, that includes:

1. 1) For Surgical Assistant

   1. A) Certification of completion from a medical education program approved by the Division or graduation from a United States Military Program that emphasizes surgical assisting;
   2. B) A complete work history since completion of a surgical assistant program;
   3. C) Verification of successful completion of a national certifying examination set forth in Section 1485.10(c).

   4. D) Current certification by one of the following organizations:

      1. i) National Surgical Assistant Association on Certification of Surgical Assistants;
      2. ii) Liaison Council on Certification for the Surgical Technologist as a certified first assistant; or
      3. iii) American Board of Surgical Assistants.
   5. E) The required fee set forth in Section 1485.80.

2) For Surgical Technologist

1. A) Proof of completion of a surgical technologist program approved by the Division;
2. B) A complete work history since completion of a surgical technologist program;
3. C) Successful completion of the surgical technologist national certification examination provided by the Liaison Council on Certification for the Surgical Technologist or its successor agency;
4. D) Current certification from the Liaison Council on Certification for the Surgical Technologist or its successor agency and proof that the applicant has met the requirements set forth for certification; and
5. E) The required fee set forth in Section 1485.80.

b) Certification from the state or territory of the United States in which the applicant was originally licensed, and the states in which the applicant is currently licensed, stating:

1. 1) The time during which the applicant was licensed/registered in that jurisdiction;
2. 2) Whether the file on the applicant contains any record of disciplinary actions taken or pending.