Florida

Board

of

Medicine

Applicants who answer “Yes” to any of the Health History questions on the application are required to submit the following documentation to the board office:

Self-Explanation – Applicants must submit a letter in your own words explaining the medical condition(s) or occurrence(s). Include a description of all treatments and diagnoses you have received for any condition(s)/impairment(s) you are/have been treated for. Include all medications prescribed and all physicians/counselors that have provided treatment.

Physician(s) Letter – Applicants must submit a statement from your treating physician(s)/counselor(s) for each condition you are/were being treated for and whether or not you are currently able to safely practice Medicine. The physician’s statement should include all DSM IIIR/ DSM IV, Axis I, II, and III diagnoses.

Applicants who have ever been denied licensure, had disciplinary action taken against their license, or have action pending against their license to practice any health care related profession by a licensing authority are required to submit the following documentation to the board:

Self-Explanation – Applicants who have listed disciplinary action on the application must submit a letter in your own words describing the circumstances of the action.

Agency Records – All relevant documentation regarding the action should be sent to the board office by the licensing agency. If the records are not available, you must have a letter on agency letterhead sent from the licensing agency attesting to their unavailability.

Any applicant who has ever been found guilty of or pled guilty or no contest/nolo contendere to any charge other than a minor traffic offense must list each offense on the application. Failure to disclose criminal history may result in denial of your application. Each application is reviewed on its own merits.

The Board of Medicine has created guidelines for specific offenses to be cleared in the board office; however, staff cannot make determinations in advance as laws and rules do change over time. Violent crimes and repeat offenders are required to be presented to the Board of Medicine for review. Evidence of rehabilitation is important to the board members when making licensure decisions.

Applicants with prior criminal convictions are required to submit the following documentation to the board:

Self-Explanation – Applicants who have listed offenses on the application must submit a letter in your own words describing the circumstances of the offense.

Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Completion of Probation/Parole/Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, you must have a letter on court letterhead sent from the clerk of the court attesting to their unavailability.

Effective July 1, 2012, Section 456.0635, Florida Statutes (F.S.), provides that health care boards or the department shall refuse to issue a license, certificate or registration and shall refuse to admit a candidate for examination if the applicant:

1. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under Chapter 409, F.S., (relating to social and economic assistance), Chapter 817, F.S., (relating to fraudulent practices), Chapter 893, F.S., (relating to drug abuse prevention and control) or a similar felony offense(s) in another state or jurisdiction unless the candidate or applicant has successfully completed a drug court program for that felony and provides proof that the plea has been withdrawn or the charges have been dismissed. Any such conviction or plea shall exclude the applicant or candidate from licensure, examination, certification, or registration, unless the sentence and any subsequent period of probation for such conviction or plea ended:
   1. For the felonies of the first or second degree, more than 15 years from the date of the plea, sentence and completion of any subsequent probation;
   2. For the felonies of the third degree, more than 10 years from the date of the plea, sentence and completion of any subsequent probation;
   3. For the felonies of the third degree under section 893.13(6)(a), F.S., more than five years from the date of the plea, sentence and completion of any subsequent probation;
2. Has been convicted of, or entered a plea of guilty or nolo contendere to, regardless of adjudication, a felony under 21 U.S.C. ss. 801-970 (relating to controlled substances) or 42 U.S.C. ss. 1395-1396 (relating to public health, welfare, Medicare and Medicaid issues), unless the sentence and any subsequent period of probation for such conviction or pleas ended more than 15 years prior to the date of the application;
3. Has been terminated for cause from the Florida Medicaid program pursuant to section 409.913, F.S., unless the candidate or applicant has been in good standing with the Florida Medicaid program for the most recent five years;
4. Has been terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program, unless the candidate or applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years before the date of the application;
5. Is currently listed on the United States Department of Health and Human Services Office of Inspector General’s List of Excluded Individuals and Entities.

Effective January 1, 2013, applicants for initial licensure must use a Livescan service provider to submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal history records that may pertain to an applicant. The results of the search will be returned to the Care Provider Background Screening Clearinghouse and made available to the Department for consideration during the licensure process. The fingerprints submitted by the applicant will be retained by FDLE and the Clearinghouse. All costs for conducting a criminal history background screening are borne by the applicant.

Please ensure that the Originating Agency Identification (ORI) number is provided to the service provider when you submit your fingerprints. If you do not provide an ORI number or if you provide an incorrect ORI number to the service provider, the board office will not receive your fingerprint results. The applicant is fully responsible for selecting the service provider and ensuring submission of the prints to the Department.

You can find an approved Livescan Service Provider at https://www.flhealthsource.gov/background-screening.

Please take this form with you to the Livescan provider. Please check the service provider’s requirements to see if you need to bring any additional items. Also verify that the Originating Agency Identification (ORI) number submitted by the livescan service provider matches the information provided.

If you have been named in any malpractice suits, or have answered “yes” to any of the questions in the application, anticipate the possibility that additional information be requested.

You can check the status of the application by clicking the “Check Status” link.  Once you have submitted your application, it will take up to 15 days before the information on your status is up to date.  You will need to know your File ID number and your date of birth to access the information.  Your File ID number will be given to you once you start the application process.

We recommend that you do not make any commitments based upon expectation of licensure until you are actually licensed.  Some applicants suffer significant costs by signing mortgages and committing to a start date prematurely.

Read instructions before and while you complete the application.  Failure to do so may result in delays in processing your application.
One application is not accelerated at the expense of another, particularly if there is a premature commitment to start practicing.  All applicants are handled equally and fairly.  The application process may take between two to six months to complete depending on your credentials.

Applicants can help expedite the application process by including all relevant materials with their application packets (anesthesiologist assistant diploma, NCCAA certificate, etc).  We will mail you a deficiency letter approximately 30 days after receiving your application.  Please refrain from contacting our office until after you have received your initial deficiency letter.  E-mail contact is more efficient.  Time spent on the telephone impacts time available for staff to process applications.

Please direct questions or comments to MQA_AnesthesiologistAssistant@doh.state.fl.us.
We process applications, mail, e-mails, and telephone calls in date order.

When issuing licenses, we have a strict policy of fairness.  One application will not be accelerated at the expense of another.  All applications will be handled equally and fairly.  Also, the less time reviewers spend responding to duplicate e-mails and telephone calls, the faster applications can be reviewed.  The standard procedures for the reviewers are:

Return phone calls within 24 hours.
Check mail within one week from receipt date.
Respond to e-mails within one week.

It could take up to 10 days to issue your license after completion of your application. It will take approximately 7 business days to receive your license in the mail after issuance. To view your license before receiving the actual license in the mail, click LOOKUP. Your license number will appear on the web site 24 to 48 hours after it is issued.

The State of Florida operates under Chapter 286, Florida Statutes, commonly referred to as the “Sunshine Law.”  This law requires that board and Council meetings are public.  All information that you provide to the Department is public record and shall be open to public inspection as required by 119.07 F. S., except financial information, examination records, and patient records.

Personal Appearances before the Anesthesiologist Assistant Committee may be required for a variety of reasons: e.g., malpractice, health history, conviction, disciplinary actions, etc.  If an appearance is required, we will notify you by mail including the date, time, location, and reason(s) for the appearance.