Arizona Administrative Code › Title 4 - PROFESSIONS AND OCCUPATIONS › Chapter 18 - NATUROPATHIC PHYSICIANS MEDICAL BOARD › Article 2 - LICENSES; SPECIALISTS CERTIFICATES; CONTINUING MEDICAL EDUCATION; RENEWAL › Section R4-18-209 - Reinstatement of a Suspended, Revoked, or Surrendered License or Certificate

Current through Register Vol. 30, No. 28, July 12, 2024
A. A person may
				apply to the board for the termination of the suspension or reissuance of a
				revoked license. Pursuant to A.R.S. §
									32-1551,
				the board shall make its determination on each application as it deems
				consistent with the public health, safety and just in the circumstances. The
				applicant must provide the Board with;
1. A
				completed application form, provided by the Board that is signed, dated, and
				verified; which shall include the following information;
a. Applicant's full name and any former names
				used by the applicant;
b. Place and
				date of birth;
c. Social Security
				number;
d. Home, business, and
				e-mail addresses;
e. Home,
				business, and cell phone numbers;
f. A completed Arizona Statement of
				Citizenship and Alien Status for State Public Benefits, and copy of
				evidence;
g. The name of the
				approved naturopathic college applicant graduated from, date of graduation, and
				date of clinical training completion;
h. Documentation showing that the basis for
				the suspension or revocation has been removed, and that suspension termination
				or reinstatement of the license or certificate, does not constitute a threat to
				the public health or safety;
i. A
				list of all license or certificates issued or denied by any agency. Applicant
				must cause to have a document submitted directly to the Board from each agency
				listed, containing the applicant's name, date of issuance or denial, current
				status and whether or not any disciplinary actions are pending or have ever
				been taken;
j. Whether applicant
				has ever been arrested, charged with, convicted of, or entered into a plea of
				no contest to a felony or a misdemeanor;
k. Whether applicant has ever had a
				naturopathic medical license or certification, or any other health profession
				license or certification denied, suspended, rejected or revoked by any
				agency;
l. Whether applicant has
				ever been disciplined by any agency for any act of unprofessional conduct as
				defined in A.R.S. §
											32-1501;
m. Whether in lieu of disciplinary action,
				has applicant ever entered into a consent agreement or stipulation with a
				licensing agency;
n. Whether
				applicant currently has an open complaint or is involved in any open
				investigation in any agency or court of law, in any state or territory of the
				United States;
o. Whether applicant
				has ever had the authority to prescribe, dispense, or administer a natural
				substance, drug, or device limited, restricted, modified, denied, surrendered
				or revoked by a federal or state agency or court of law;
p. Whether applicant has ever been found
				medically incompetent;
q. Whether
				applicant has ever been a defendant in any malpractice matter that resulted in
				a settlement or judgment;
r.
				Whether applicant has a medical condition that in any way impairs or limits
				applicant's ability to practice medicine, and;
s. A detailed explanation and supporting
				documentation for each affirmative answer to questions regarding the
				applicant's background;