North Carolina Administrative Code › Title 21 - OCCUPATIONAL LICENSING BOARDS AND COMMISSIONS › Chapter 16 - DENTAL EXAMINERS › Subchapter I - ANNUAL RENEWAL OF LICENSE AND CONTINUING EDUCATION REQUIREMENTS: DENTAL HYGIENIST › Section .0100 - ANNUAL RENEWAL › Section 16I .0101 - APPLICATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A renewal
				  application for a dental hygiene license shall be submitted electronically
				  before midnight on January 31 of each year through the Board's website:
				  www.ncdentalboard.org. The renewal application shall include:
(1) dental hygiene license number;
(2) full name;
(3) mailing address and any secondary address
				  the licensee wishes to provide;
(4)
				  telephone number;
(5) fax
				  number;
(6) email
				  address;
(7) citizenship or
				  immigration status, with verifying documentation;
(8) whether, during the calendar year
				  preceding the application, the licensee has:
(A) been summoned to court or before a
				  magistrate for the violation of any law or ordinance or for the commission of
				  any felony or misdemeanor;
(B) been
				  arrested for the violation of any law or ordinance or for the commission of any
				  felony or misdemeanor;
(C) been
				  taken into custody for the violation of any law or ordinance or for the
				  commission of any felony or misdemeanor;
(D) been indicted for the violation of any
				  law or ordinance or for the commission of any felony or misdemeanor;
(E) been convicted or tried for the violation
				  of any law or ordinance or for the commission of any felony or
				  misdemeanor;
(F) been charged with
				  the violation of any law or ordinance or for the commission of any felony or
				  misdemeanor;
(G) pleaded guilty to
				  the violation of any law or ordinance or for the commission of any felony or
				  misdemeanor;
(H) been disciplined
				  by any professional licensing board; or
(I) had a malpractice suit settled or pending
				  against the licensee;
(9) whether the licensee has been
				  investigated for employee misclassification as an independent contractor within
				  the five years preceding the application;
(10) employment status as a dental hygienist
				  as of the date of the application, including;
(A) whether the licensee is currently working
				  as a dental hygienist;
(B) name of
				  the practice in which the licensee provides services;
(C) primary setting in which the licensee
				  provides services;
(D) type of
				  employer for which the licensee works; and
(E) number of hours the licensee works in an
				  average week;
(11) a
				  report of the licensee's completion of continuing education hours related to
				  clinical patient care during the calendar year preceding the application, or
				  the licensee's exemption from reporting;
(12) whether the licensee holds an unexpired
				  CPR certification;
(13) whether the
				  licensee has been employed as a limited supervision hygienist as set forth in
				  21 NCAC
				  16Z during the calendar year preceding the
				  application; and
(14) a written
				  statement certifying that the information submitted is accurate to the best of
				  the licensee's knowledge.