In addition to the information required by Plc 304.03, the applicant shall provide the following information:

1. (a) Whether the applicant is applying for a license to practice reflexology, structural integration, or Asian bodywork therapy; and

2. (b) In addition to the name of each jurisdiction where the applicant holds or held any professional license, certificate, registration, approval, authorization, or any other governmental approval to practice reflexology, structural integration, or Asian bodywork therapy, the same information for any other related or unrelated profession the applicant is or has been licensed to practice, and for each, the following:

   1. (1) The profession in which the applicant is or was licensed;
   2. (2) The number of years the applicant was licensed; and
   3. (3) The status of the license or certificate, including whether a license or certificate was denied or is active, suspended, or revoked.

Source. #14444, eff 1-26-26, EXPIRES: 1-26-36