102 license 2026

1. Click ‘Get Form’ to open the 102 license in the editor.
2. Begin by entering your personal information in fields 1 to 5. Fill in your first name, middle name, last name, and date of birth accurately.
3. In field 2, provide the name or title of your nursing license in English. Ensure this matches official documents.
4. Enter your nursing license number and the date it was issued in field 3. Double-check for accuracy.
5. Indicate the states where you are applying for a license in field 4 by checking the appropriate boxes.
6. Authorize confirmation of your nursing license by signing and dating the form in field 5.
7. Complete additional contact information including email and phone numbers in fields 6 and 7.

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