Get Www_idfpr_com_dpr_apply_forms_md-ex

Filling out the Www_idfpr_com_dpr_apply_forms_md-ex is an essential step in the licensure process under Illinois law. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the form and open it in your designated editor.
2. In the applicant section, provide your full name, including your last, first, and middle names.
3. Enter your date of birth in the format of month/day/year.
4. Fill in your social security number, ensuring that you input it in the correct format.
5. Complete the address field with your street address, city, state, and zip code.
6. If applicable, provide your maiden or given surname.
7. Refer to the reference sheet to enter the profession name and the corresponding three-digit profession code for your Illinois application.
8. If you have an Illinois temporary license number, include it in the appropriate section.
9. Record the issuance date of your temporary license, if applicable.
10. The postgraduate clinical training program director must fill out the remainder of the form, certifying the applicant's completion of clinical training.
11. Provide detailed information about the postgraduate clinical training program, including the name and address of the hospital.
12. The program director must sign and date the certification at the end of the form.
13. Once you have completed all fields, review the form for accuracy. Save your changes, and proceed to download, print, or share the completed form as needed.

Start filling out your documents online to ensure a smooth licensure process.