Physician

For questions about renewing your active Physician license, contact us at medbd@dch.ga.gov or at 404-656-3913.

For questions about your pending application for Physician licensure (Intial or Reinstatement),  if your last name begins with the alphabetic characterr:

A to D     Katonya Reynolds at kreynolds@dch.ga.gov / 404-463-6162,
E to K     Debra Reser at  debra.reser@dch.ga.gov / 404-657-6491, 
L to P     Michalen Hughes at mhughes@dch.ga.gov / 404-657-6490,
Q to Z     Deborah Bruce at dbruce@dch.ga.gov / 404-656-7067
 
The Application Process

When you apply, there are additional documents needed to complete your application. In order to ensure a smooth process send these documents to the Board in a single envelope (instructions). The packet you send should include your printed application (if you apply online, print the PDF application you recieved). 

Application and Forms for Initial Physician Licensure


Checklist for Initial Physician Application 

Initial Physician License Application
   FORM A -  Certificate of Postgraduate Training
   FORM B -   Reference Form

   FORM D -   Affidavit of Applicant
   FORM D2 - Affidavit for Medical Board License
   FORM E -   Mandatory Malpractice Questionnaire

   FORM G -  Specific Power of Attorney

Reinstatement of Georgia Physician License

Institutional Physician License

Volunteer in Medicine License

Physician Teacher License

Educational Training Certificate

 

Other Physician Forms and Information

Physician Profile Information and Forms

Inactive Status Application 

Decorative Wall License Certificate (Physician)

Duplicate License Card (Wallet Card)

Frequently Asked Questions