Before applying for licensure, please familiarize yourself with the general licensing policies.

A completed, notarized application with photo and fee in the amount of $190.00 in the form of a bank check or money order payable to, “Treasurer, State of Connecticut”;

The applicant’s current curriculum vitae (CV) or synopsis of professional activity since completion of the applicant's physician assistant educational program;

Official verification, sent directly from the National Commission on Certification of Physician Assistants (NCCPA) to this Department, of certification status;

If applicable, official verification form sent directly from each state licensing authority where a license or certification is or has ever been held, and

Verification from the appropriate authority confirming the applicant's most recent employment; including dates and overall evaluation of your ability to practice with reasonable skill and safety.

Note:  Typically, applicants for reinstatement who have not been in active, clinical practice for longer than five years are required to complete a period of refresher training or pass an examination.  Applicants will receive further information from the Department upon receipt of all required documentation.

Please arrange for all supporting documentation to be sent directly from the source to: