Ariz. Admin. Code § 4-18-203

Current through Register Vol. 30, No. 45, November 8, 2024

Section R4-18-203 - License by Endorsement

In addition to the requirements of R4-18-201, an applicant for licensure by endorsement shall meet the requirements of A.R.S. Title 32, Chapter 14, and provide the Board:

1. A completed application form, provided by the Board that is signed, dated, and verified, which shall include the following information;

a. Applicant's full name and any former names used by the applicant;

b. Place and date of birth;

c. Social Security number;

d. Home, business, and e-mail addresses;

e. Home, business, and cell phone numbers;

f. A completed Arizona Statement of Citizenship and Alien Status for State Public Benefits, and copy of evidence;

g. The name of the approved naturopathic college applicant graduated from, date of graduation, and date of clinical training completion;

h. The date applicant took and passed the required NPLEX examinations of Part I; Biomedical examination, Part II; Clinical Science examination, Part II; Core Clinical Science Examination, and the Clinical Elective examinations in acupuncture, and minor surgery. The date applicant took and passed the examination in Arizona naturopathic jurisprudence that is administered by the Board;

i. A list of all license or certificates issued or denied by any Agency. Applicant must cause to have a document submitted directly to the Board from each agency listed, containing the applicant's name, date of issuance or denial, current status, and whether or not any disciplinary actions are pending or have ever been taken;

j. Whether applicant has ever been arrested, charged with, convicted of, or entered into a plea of no contest to a felony or a misdemeanor;

k. Whether applicant has ever had a naturopathic medical license or certification, or any other health profession license or certification denied, suspended, rejected or revoked by any agency;

l. Whether applicant has ever been disciplined by any agency for any act of unprofessional conduct as defined in A.R.S. § 32-1501;

m. Whether in lieu of disciplinary action, has applicant ever entered into a consent agreement or stipulation with a licensing agency in any state or territory of the United States;

n. Whether applicant currently has an open complaint or is involved in any open investigation in any agency or court of law, in any state or territory of the United States;

o. Whether applicant has ever had the authority to prescribe, dispense, or administer a natural substance, drug, or device limited, restricted, modified, denied, surrendered or revoked by a federal or state agency or court of law; in any state or territory of the United States;

p. Whether applicant has ever been found medically incompetent;

q. Whether applicant has ever been a defendant in any malpractice matter that resulted in a settlement or judgment;

r. Whether applicant has a medical condition that in any way impairs or limits applicant's ability to practice medicine, and;

s. A detailed explanation and supporting documentation for each affirmative answer to questions regarding the applicant's background;

2. A document submitted directly to the Board by the agency by whom the applicant is licensed as a naturopathic physician that is signed and dated by an official of the agency and that contains:

a. The applicant's name;

b. The date of issuance of the license;

c. The current status of the license;

d. A statement of whether the applicant has ever been denied a license by the agency, and;

e. A statement of whether any disciplinary action is pending or has ever been taken against the applicant;

3. A copy of the applicant's complete NPLEX examination record, to be sent directly to the Board by the North American Board of Naturopathic Examiners "NABNE") or its successor;

4. A complete transcript sent directly to the board from the approved school of naturopathic medicine from which the applicant graduated. The transcript shall include the date of graduation and the date of completion of clinical training.

5. Applicant must provide evidence of being actively engaged, for at least three years immediately preceding the application, in one or more of the following:

a. The active practice as a licensed doctor of naturopathic medicine;

b. Participation in an approved internship, preceptorship or clinical training program in naturopathic medicine, as defined in A.R.S. § 32-1501(4), (5), (7);

c. Participation in an approved postdoctoral training program in naturopathic medicine, as defined in A.R.S. § 32-1501(6);

d. Active in the resident study of naturopathic medicine at an approved school of naturopathic medicine, as defined in A.R.S. § 32-1501(8)(a) and (b);

6. A complete and legible fingerprint card, including the DPS processing fee;

7. A passport size photograph taken within 60 days prior to application submission, that is signed on the back by the applicant;

8. The fees specified in R4-18-107;

9. Applicants who were licensed in another state or a Canadian province before January 1, 2005, shall include evidence of completion of additional 60 hours of continuing medical education ("CME") in the subject of pharmaco-therapeutics. The CME must be offered, sanctioned, or accredited by one of the organizations referenced in R4-18-205(B)(1), (2)(a), (b), (c) or (4)(a), (b), (c), and include an examination. In the event the applicant cannot provide satisfactory evidence of completion of the required pharmacotherapeutics, or the required examinations, pursuant to A.R.S. § 32-1524(E), and (G)(3), the applicant will have an additional 365 days from the date the board notifies the applicant of the deficiency, to supply satisfactory evidence of completion.

Ariz. Admin. Code § R4-18-203

New Section made by final rulemaking at 8 A.A.R. 3702, effective August 9, 2002 (Supp. 02-3). Amended by Final rulemaking at 21 A.A.R. 2009, effective 9/1/2015.