Form 08-4151 - Dispensing Optician Application For Licensure printable pdf download

STATE OF ALASKA

DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT

DIVISION OF OCCUPATIONAL LICENSING

ALASKA STATE BOARD OF DISPENSING OPTICIANS

P.O. BOX 110806

JUNEAU, ALASKA 99811-0806

(907) 465-5470

E-mail: license@dced.state.ak.us

DISPENSING OPTICIAN APPLICATION FOR LICENSURE

AS 08.71.080 states that it is unlawful for a person to act as a dispensing optician in the State of Alaska or to advertise or

otherwise indicate to the public that he or she is qualified to practice as a dispensing optician without first obtaining a license

through the procedures set forth in the Dispensing Opticians Act, AS 08.71.

LICENSURE BY EXAMINATION PROCEDURES

1. Submit a completed notarized application with photo attached and required fees postmarked 90 days before the next

exam date. (Contact division for scheduled exams and deadlines.)

2. Certified copy of high school diploma or high school transcript as required by statute.

3. Verification of 6,000 hours of training or 6,000 hours as a practicing optician per 12 AAC 30.070.

Work or training verifications shall be submitted by the licensed instructor, licensed doctor, or the supervising licensed

dispensing optician. If you received training or have work experience while in a nonlicensing state, it is preferred by

the board that an A.B.O./N.C.L.E. certified individual verify that training or work experience.

4. 4,000 of the 6,000 hours of experience may be substituted by proof of an associate degree in opticianry as allowed

by AS 08.71.110(a)(2).

5. All supporting documents (verifications, transcripts, etc.) must be postmarked 90 days before the next exam date. All

completed applications are reviewed by each board member. You will receive a status of application form letter from

the board office within 30 days of receipt of your application. After board approval, an exam scheduling letter will be

sent. If your file is incomplete or has been denied, you will be sent a letter of explanation.

6. If you wish to practice opticianry in Alaska while waiting for exam approval, to take the exam or for exam results, you

must register as an apprentice, regardless of the number of years of work experience or training that you may have.

(Please call board office for forms.)

Candidates will be administered the National Opticianry Competency Examination (for spectacles) and/or the Contact Lens

Registry Examination (for contacts) in addition to the State's practical examination for each applicable category.

AMERICAN BOARD OF OPTICIANRY (ABO) CERTIFICATION

If you have already passed the national exam(s), please request of the ABO that the following information be provided on your

behalf. It would be helpful if the ABO were given the year in which you took the exam(s), specify spectacles and/or contact

lenses and provide them with your social security number.

1. Name and social security number (if available)

2. Score or grade

3. Pass or Fail and cut-off score (if available)

4. Exam name and specialty area (spectacles/contact lenses)

5. Date or year taken

6. Currently certified by ABO

7. Signed and dated by authorized agent of ABO

08-4151 (Rev. 8/00)

Form 08-4151 - Dispensing Optician Application For Licensure