PURPOSE: This rule provides information regarding requirements to applicants desiring licensure in Missouri for practice as a physician assistant.

1. (1) Applicants shall furnish satisfactory evidence as to their good moral character including a letter of reference from the director of their physician assistant program.
2. (2) Applicants must present satisfactory evidence of completion of a physician assistant program accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association or by its successor agency the Commission for the Accreditation of Allied Health Education Pro grams or its successor agency. A photostatic copy of the applicant’s diploma shall be submitted as evidence of satisfactory completion.
3. (3) Applicants who did not complete a physician assistant program and were employed as physician assistants for three (3) years prior to August 28, 1989, shall have written verification of employment, made under oath, submitted to the board from the physician who supervised the applicant. The supervising physician shall also submit a letter of reference documenting the performance of the physician assistant during the employment period. This verification of employment and letter of reference shall be accepted in lieu of the requirements in section (1) and (2) of this rule.
4. (4) Applicants shall, upon a form provided by the board, designate any and all physicians who will serve as their supervising physician. A change of physician supervision, for any reason, must be submitted to the board within fifteen (15) days of such occurrence.
5. (5) Applicants shall have verification of passage of the certifying examination and active certification submitted to the board from the National Commission on Certification of Physician Assistants.
6. (6) Applicants are required to make application upon forms prepared by the board.
7. (7) No application will be considered unless fully and completely made out on the specified form and properly attested.
8. (8) Applicants shall attach to the application a recent unmounted photograph not larger than three and one-half inches by five inches (3 1/2" × 5").
9. (9) Applications shall be sent to the State Board of Registration for the Healing Arts, PO Box 4, Jefferson City, MO 65102.
10. (10) Applicants shall submit the licensure application fee in the form of a cashier’s check or money order drawn on or through a United States bank made payable to the State Board of Registration for the Healing Arts. Personal checks will not be accepted.
11. (11) Applicants shall have verification of licensure, registration and/or certification submitted from every state and/or country in which the applicants have ever held privileges to practice. This verification must be submitted directly from the licensing agency and include the type of license, registration or certification, the issue and expiration date, and information concerning any disciplinary or investigative actions.
12. (12) Applicants must submit a complete curriculum vitae from high school graduation to the date of application submission. This document shall include the name(s) and address(es) of all employers and supervisors, dates of employment, job title, and all professional and nonprofessional activities.
13. (13) When an applicant has filed an application and an appropriate fee, to be established by the board in conjunction with the director of the Division of Professional Registration for licensure and the application is denied by the board or subsequently withdrawn by the applicant, that fee will be retained by the board as a service charge.
14. (14) The board may require the applicant to make a personal appearance before the board and/or commission prior to rendering a final decision regarding licensure.
15. (15) An applicant may withdraw an application for licensure anytime prior to the board’s vote on the applicant’s candidacy for licensure.

AUTHORITY: sections 334.125, 334.735, 334.738, 334.742 and 334.743, RSMo Supp. 20 CSR 2150-7 1999.* This rule originally filed as 4 CSR 150-7.100. Emergency rule filed Sept. 15, 1992, effective Sept. 25, 1992, expired Jan. 22, 1993. Original rule filed April 2, 1992, effective Dec. 3, 1992. Amended: Filed Jan. 3, 1997, effective July 30, 1997. Amended: Filed July 25, 2000, effective Dec. 30, 2000. Moved to 20 CSR 2150-7.100, effective Aug. 28, 2006. *Original authority: 334.125, RSMo 1959, amended 1993, 1995; 334.735, RSMo 1989, amended 1996, 1997, 1998; 334.738, RSMo 1989, amended 1998; 334.742, RSMo 1989, amended 1998; 334.743, RSMo 1989, amended 1993, 1995, 1998.