Applications for Change of Licensure Status

Inactivation/Reactivation of a License

For licensees wishing to inactivate or reactivate an Ophthalmic Dispenser License. A license may be inactivated for up to 10 years and may be reactivated at any time. Please see the application for details.

• Inactivation/Reactivation Application (pdf)

Reinstatement

For licensees who wish to reinstate an expired license. A license may only be reinstated within two years of its expiration. Please see the application for details.

• Reinstatement Application (pdf)

Upgrade to Dual Ophthalmic Dispenser License

For licensees who currently hold a Limited Ophthalmic Dispenser License (no longer available) and would like to upgrade to a full (Dual) Ophthalmic Dispenser License.  Applicants for licensure upgrade are required to pass a modified version of the state board exam.  Please see the application for details.

• Upgrade to Dual Ophthalmic Dispenser License Application (pdf)

Renewal of License

• Renewal Applications