Licensure Specialist, Katonya Reynolds
Physician
For questions about renewing your active Physician license, contact us at [email protected] or at 404-656-3913.
Initial Physician Licensure
When you apply, your application and the additional documents will be needed to complete your file. In order to ensure a smooth process send these documents to the Board in a single envelope (
instructions
).
Once a licensed professional and DEA holder in Georgia, you will be required to register with the Georgia PDMP
Checklist for Initial Physician
All applications for Physician Licensure should be completed online through the Board's online portal (click HERE). Applicable fees can be paid through the portal as well. Below are forms to complete and send to the Board:
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
Links to other Physician license types:
Institutional Physician License
Educational Training Certificate
Other Physician Forms and Information
Physician Profile Information and Forms
Decorative
Wall License Certificate (Physician)
For questions about your pending application for Physician licensure (Initial or Reinstatement), if your last name begins with the alphabetic character:
Licensure Specialist, Katonya Reynolds
Licensure Specialist, Dwana Robinson
Licensure Specialist, Philip Hamilton
Licensure Specialist, Debi Bruce