1. (1)(a) American Osteopathic Association Profile;

   1. (b) American Medical Association Profile; or
   2. (c) documentation of American Board of Medical Specialties (ABMS) Board Certification;
2. (2) Federation of State Medical Boards Disciplinary Inquiry form;
3. (3) Federation Credentials Verification (FCVS) report; and
4. (4) National Practitioner Data Bank Report of Action.

Subsection 58-68-301(1)(a)(i), submissions by the applicant of information maintained by practitioner data banks shall include the following:

KEY: osteopaths, licensing, osteopathic physician

Date of Last Change: January 12, 2023

Notice of Continuation: October 31, 2022

Authorizing, and Implemented or Interpreted Law: 58-1-106(1)(a); 58-1-202(1)(a); 58-68-101