Reinstatement of a Physician License that has Lapsed due to Nonrenewal

Before applying for licensure, please familiarize yourself with the general licensing policies.

 

An applicant for reinstatement of a Connecticut license that has lapsed due to nonrenewal shall arrange for the submission of the following documentation directly from the source:

 

A completed, notarized application with photo and fee in the amount of $565.00 in the form of a bank check or money order payable to, “Treasurer, State of Connecticut”;

 

A separate bank check or money order in the amount of $4.75 made payable to, “Treasurer, State of Connecticut”.  This payment covers the Department’s cost for querying the National Practitioner Data Bank;  

 

Please do not combine the above two (2) payments into one single payment as such payment can not be processed and will delay the Department's processing of your application.

 

The applicant’s current curriculum vitae (CV) including a synopsis of professional activity since completion of medical school;

 

Verification of any out-of-state licenses held, current or expired, submitted directly to this office from the source.  Please contact the jurisdiction prior to making a request as some jurisdictions charge a fee for completion of the form;

 

Verification from the appropriate authority confirming the applicant's most recent clinical employment; including dates and overall evaluation of the applicant's ability to practice medicine with reasonable skill and safety.  If the applicant is in private practice, a letter from another physician with whom the applicant has referred patients.  Such letter shall indicate dates of the referral relationship and an evaluation of the applicant's ability to practice medicine with reasonable skill and safety; and

 

Verification of completion of 25 hours of continuing medical education (CME) within the one year period immediately preceding application for reinstatement.

 

Note: Applicants for reinstatement who have not been in the active, clinical practice of medicine for longer than six (6) months are reviewed by the Connecticut Medical Examining Board.  The CMEB meets on the third Tuesday of the each month.  Typically, the CMEB requires applicants who have been out of active clinical practice for longer than two years to complete the Federation of State Medical Board’s Special Purpose Examination (SPEX).

 

All supporting documents should be mailed directly from the source to:

 

Connecticut Department of Public Health

Physician Licensure

410 Capitol Ave., MS# 12 APP

P.O. Box 340308

Hartford, CT 06134

Phone:  (860) 509-7603

Fax:  (860) 707-1931

email:  dph.healingarts@ct.gov