PURPOSE: This rule provides the requirements and time frames licensees must follow in reporting a change in supervision, name and/or address change, or to document retirement from practice.

1. (1) Licensed physician assistants who have a change of physician supervision, for any reason, must submit written notification and the required form to the board within fifteen (15) days of such occurrence.
2. (2) Licensed physician assistants must submit written notification of any address change to the board within fifteen (15) days of such occurrence.
3. (3) Licensed physician assistants whose names have changed since licensure was issued must submit a copy of the legal document verifying the name change to the board, within fifteen (15) days of such occurrence.
4. (4) Licensed physician assistants who retire from practice as a physician assistant shall file an affidavit, on a form furnished by the board, stating the date of retirement. The licensee shall submit any other documentation requested by the board to verify retirement. Licensees who reengage in practice as a physician assistant after submitting an affidavit of retirement shall reapply for licensure as required in sections 334.735 and 334.738, RSMo and pursuant to the provisions of rule 4 CSR 150-7.125.

AUTHORITY: sections 334.125, 334.735, 334.738 and 334.743, RSMo Supp. 1999.* This rule originally filed as 4 CSR 150-7.122. Original rule filed Jan. 3, 1997, effective July 30, 1997. Amended: Filed July 25, 2000, effective Dec. 30, 2000. Moved to 20 CSR 2150-7.122, 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; 334.743, RSMo 1989, amended 1993, 1995, 1998.