Arizona Administrative Code › Title 4 - PROFESSIONS AND OCCUPATIONS › Chapter 07 - Board of Chiropractic Examiners › Article 5 - LICENSES › Section R4-7-502 - Procedures for Processing Initial License Applications

Current through Register Vol. 30, No. 28, July 12, 2024
A. An applicant may obtain a license
				application package at the Board Office on business days, from the Board
				website, or by requesting that the Board mail the application to an address
				specified by the applicant. An applicant shall pay the Board a non-refundable
				$10 fee for each license application package.
B. A completed license application package
				shall be submitted to the Board office on business days. The Board shall deem
				the license application package received on the date that the Board stamps on
				the package as the date the package is delivered to the Board office;
C. To complete a license application package,
				an applicant shall provide the following information and documentation:
1. Two identical passport quality
				photographs, showing the applicant's full front face and a description of
				identifying characteristics, if any;
2. The applicant's full current name and any
				former names;
3. The applicant's
				current home and all office addresses, current home and all office phone
				numbers, all current office fax numbers, and any previous home or office
				address or addresses for the past five years;
4. The type of license, for which application
				is made;
5. All applicable
				fees.
6. A record of education
				requirements described in A.R.S. §
										32-921(B)
				 including the applicant's chiropractic
				college transcript and the applicant's certificate of attainment of passing
				scores for Parts I, II, III, and IV of the examination conducted by the
				National Board of Chiropractic Examiners;
7. Any record of being convicted of, pleading
				guilty to, or pleading nolo contendere to a misdemeanor or a felony, even if
				the record of the conviction or plea was sealed or expunged or the conviction
				was set aside or forgiven, and any record of an arrest, investigation,
				indictment, or charge within the last 12 months. The applicant shall submit any
				record of being refused a license to practice chiropractic or any other health
				care profession in this or any other state, and any record of a formal sanction
				taken against the applicant's license in this or any other state;
8. A completed fingerprint card;
9. A list of all other states or
				jurisdictions in which the applicant is or has been licensed or certified to
				practice chiropractic or any other health care profession with a verification
				of good standing for each current license or certification submitted directly
				by the licensing agency of the other state or jurisdiction;
10. The name and professional designation of
				the owner or owners of the clinic or office at which the applicant will be
				employed, if applicable;
11. The
				applicant's Social Security number;
12. The applicant's notarized signature,
				attesting to the truthfulness of the information provided by the
				applicant;
13. A score of 75% or
				higher on the Arizona Jurisprudence Examination. The applicant shall not sit
				for the Arizona Jurisprudence Examination until the application package is
				otherwise complete.