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ENEWING YOUR DO MICHIGAN EDUCATIONAL LIMITED LICENSE

1. If you have a Michigan Educational Limited Licenses, please go to

https://mylicense.mdch.state.mi.us/MyLicenseEnterpriseDCH/Login.aspx

; read all instructions carefully,

change the hospital to Henry Ford Hospital, when renewing your license and provide the HFH GME Office a

copy of your application confirmation. The HFH GME Office will reimburse you in August for the cost of the

renewal.

2. Complete the Certification of Appointment to a Michigan Training Hospital, Section I only and print your name

in the box on page 2. Return this form to the Henry Ford Hospital GME Office.

DO MICHIGAN FULL MEDICAL LICENSE

1. If you have a Michigan Full Medical License that is not expiring in advance of your start date, please scan and

send the license and the Controlled Substance License to the HFH GME Office.

2. Upon receipt of your final Educational Limited Medical License (a total of six are allowed), you must apply for a

Full Medical License at the next renewal date.

APPLYING FOR A DO MICHIGAN FULL MEDICAL LICENSE

If you are applying for a Full Medical License, please go to

https://mylicense.mdch.state.mi.us/MyLicenseEnterprise/Login.aspx

; read all instructions carefully and

provide the HFH GME Office a copy of your application confirmation.

2. Apply for both a Michigan Controlled Substance License and an independent Federal DEA number. The Federal

DEA number application may not be made until the Full Medical License is received.

3. You are responsible for ensuring that your Full Medical License, Controlled Substance License and DEA number

are renewed at the appropriate time.

4. Upon receipt of your Full Medical License, Controlled Substance License and DEA Number, please scan and send

to the HFH GME Office.

5. The Medical Education Office will reimburse you $170 in August.

2/15/13

Diversity Information Page 3

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