Licensee Services

The following licensee and registrant services are offered by the Board and Commission.  Many services can be accessed using the Licensee Portal.

Update Contact Information

Amend or change home, practice, or other addresses, telephone numbers, and email addresses and specify which one to use for official Board and Commission communications and which to make public.

Address Change
  • Alabama law requires licensees to notify the Commission of an address change within 15 days (Ala. Code § 34-24-338).
  • Once you have updated your address, you can print a new license/ACSC certificate with the new address.
Name Change
  • You must apply for a name change using the Application for Name Change.
  • Provide the legal document verifying the name change (marriage certificate, divorce decree, court order).
  • New annual license and ACSC certificates will be issued with the new name at no charge.
  • For a new wall certificate, please use the replacement wall certificate request ($25 charge).

Lost or Destroyed Wall Certificate

For a new wall certificate, please use the Wall Certificate Replacement Request Form ($25 charge).

New licenses issued after Oct. 15, 2020, bear a new certificate design.  Licensees wishing to replace their existing wall certificate with the new design may do so at no charge by returning their current certificate along with the wall certificate replacement request form.

Duplicate Annual Renewal Certificates

Duplicate annual license and ACSC renewal certificate can be printed at the Licensee Portal:

  • Log in using your last name and the last five digits of your social security number.
  • Scroll down to License Information
  • In the table of listed licenses and registrations is a column entitled “Certificate” – click the word “Print” in that column of the appropriate row.

Board Certification

Update or add an American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) board certification by clicking the Edit or Delete columns or by clicking “Add New.”

Primary Specialty

Modify your active clinical practice and/or office-based surgery status and modify your primary specialty and/or primary place of employment.

Other State Licenses

Modify the list of other states in which you hold medical licensure.

Apply for a Pain Management Registration

You should first review the web page concerning pain management registrations.

Click “Apply PM” and you will be taken to the online application

Requirements for registration:

  • DEA registration
  • ACSC
  • PDMP registration
  • Medical Director certification
  • Physical address of pain management services location
  • List of all physicians who work at the practice location
  • Payment of initial registration fee ($100)

Apply for Approval of a Collaborative Practice

You should first review the web page concerning collaborative practices.

Click “Apply CP” and you will be taken to the online application.

Requirements for application:

  • Physician and CRNP/CNM demographic information
  • Number of hours the CRNP/CNM will practice per week in this collaborative agreement
  • Names, practice locations, and hours of any out of state agreements
  • Collaborative Practice Quality Assurance Plan (copy of the same form provided to the Alabama Board of Nursing)
  • Written covering physician agreement (optional)
  • Payment of non-refundable, non-transferable commencement fee ($200)

Document Upload

If a licensee has been asked to provide documents to the Board or Commission, the Document Upload feature at the Licensee Portal may be utilized.  This upload feature should only be used when Board staff has requested you to do so or you have informed Board staff that you have uploaded documents.

Renewal History

Review and print past license and ACSC renewal applications.

Click the printer icon in the Renewal column of the license/ACSC renewal application you wish to print.

CME History

You can use this feature for your personal CME history database or to upload documentation in response to a request from the Board or Commission.