Get Or Omb Verification Of Licensure And Certification Of State Board Written Examination Grades 2021-2025

Filling out the OR OMB Verification of Licensure and Certification of State Board Written Examination Grades online is essential for applicants seeking licensure. This guide provides clear and step-by-step instructions to ensure that you complete the form accurately.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the upper portion of the form with the required personal information, including your last name, first name, other names you have been known by, middle name, date of birth, last four digits of your Social Security Number, license number, and date issued.
3. Provide your street address, city, state, and zip code.
4. Include your authorization for the release of all pertinent information to the Oregon Medical Board by signing and dating the form.
5. The State Board you are applying to will complete the lower portion of the form, which includes details like the license number, date issued, current status, and examination specifics.
6. Ensure the State Board checks whether you are under investigation or if your license has faced any disciplinary action. They must attach any necessary details.
7. The State Board will certify the information, sign, and affix their seal on the form.
8. Once completed, the State Board must send the form directly to the Oregon Medical Board as instructed.
9. You can save any changes you made to the form, download it for your records, print it out if necessary, or share it with relevant parties.

Complete your forms online today for a smoother application process.