Form Il486-1019 - Application For Licensure And/or Examination Page 4
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22In order for your application to be processed,
ALL REQUIRED SUPPORTING DOCUMENTATION MUST BE SUBMITTED
with the application and required fee unless otherwise directed in the instructions.
Supporting Documentation
ENDORSEMENT OF
LICENSE
1.
ED (Certifi cation of Education)--This document must be completed by the
authorized offi cial of the university from which your veterinary education
was obtained. School seal must be affi xed.
For assistance--Call one of
the following numbers and
2.
CT (Certifi cation of Licensure)--If you have ever held a license as a
state that you are applying
veterinarian or other related license, this document must be completed by
to become licensed as a
all jurisdictions of the United States in which you have ever been licensed.
veterinarian and need help with
You are authorized to photocopy the form if necessary. You must direct the
your application:
licensing agency/board to return completed form CT directly to you.
1-800-560-6420
TTY - 1-866-325-4949
3.
Examination Scores--The Veterinary Licensing Examination scores must
be reported directly to this Division by The American Association of
Please allow 3 weeks from
Veterinary State Boards, 380 W. 22nd. Street, Suite 101, Kansas City,
mailing your application before
MO 64108, telephone number 877-698-VIVA, website:
making an inquiry concerning
VIVA/#Transfer.
its status.
4. Fee Payment--Fee payment must be in the form of a check or money order
and made payable to the Department of Financial and Professional Regulation.
5. Forward four-page application and fee payment to: Illinois Department
of Financial and Professional Regulation, ATTN: Division of Professional
Regulation, P.O. Box 7007, Springfi eld, Illinois 62791.
RESTORATION
Supporting Documents
1.
RS (Restoration of Licensure)--This document must be completed. The
IMPORTANT NOTICE:
fee payment amount is indicated in the Offi cial Use Only box located on this
Th ese Restoration Instructions
form. If this form was not included in the application packet, you must obtain
apply only to those veterinari-
one by contacting the Department of Financial and Professional Regulation
ans whose licenses have been on
Call Center at 1-800-560-6420.
inactive status, or in non-renewed
status, for fi ve or more years.
2.
Continuing Education Verifi cation - All applicants for restoration MUST
submitverifi cation of completion of 40 hours of continuing education
If your license has been inac-
obtained within the 24 months immediately preceding submission of
tive, or in non-renewed status,
your application for restoration. Verifi cation must be in the form of
for less than fi ve years, you
should contact the Department
a certifi cate(s) of attendance issued by the sponsor of the continuing
of Financial and Professional
education program(s).
Regulation at 1-800-560-6420
for detailed instructions on how
to restore it to active status.
Veterinarian Instructions - Page 4
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Dtf-806 - Application For Refund And/or Credit Of Sales Or Use Tax Paid On Casual Sale Of Motor Vehicle - New York State Department Of Taxtation
Financial
Form Pi-1 - Application For Licensure - Oregon Department Of Public Safety Standards And Training
Legal
Related Categories
Parent category: Business