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G4096177 application for a locum tenens license as a MD - health state tn

G4096177 application for a locum tenens license as a MD - health state tn 2025

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The document outlines the application process for a Locum Tenens License as a Medical Doctor in Tennessee. It details the required attachments, including payment, identification documents, proof of citizenship, and a criminal background check. The application also includes sections for personal information, licensure history, competency questions regarding medical conditions and substance use, and an affidavit to be notarized. Additionally, it emphasizes compliance with the SAVE Act for verifying citizenship status.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the designated fields, including your name, date of birth, and social security number. Ensure accuracy as this information is crucial for processing your application.
Complete the 'Initial Practice Setting' section by briefly describing why you are applying for this license and the context in which it will be used.
In the 'Licensure Information' section, list all states where you have ever held a medical license. Be thorough and include any necessary additional pages if required.
Answer all competency questions honestly. If any answers are affirmative, prepare to attach an explanation on a separate sheet as instructed.
Fill out the affidavit at the end of the application in front of a notary public. This step is essential for validating your application.
Attach all required documents such as proof of citizenship, photographs, and payment details before submitting your completed application.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much does a Tennessee medical license cost?

Successfully completed the board exam; Demonstrates competency, as determined by the board; Completed a three-year post-graduate training program in the applicants licensing country; and. Has otherwise practiced medicine for at least three years as a physician outside the United States.

How do I verify a Tennessee medical license?

The license number also denotes the educational level and year of licensure. If we look for a medical license number example, it might start with the word MD and be followed by some number. In many other states, it is purely numeric, and that shows its diversity in different states.

How long does it take to get a Tennessee medical license?

Absent any complicating factors, the average application processing time is ten (10) to twelve (12) weeks. Once the application is completed, your file will be reviewed, and an initial licensure determination made. You will be notified by letter of the initial determination.

How to check license status TN?

Eligible physicians can qualify to practice medicine across state lines within the Compact if they meet the Compacts agreed-upon eligibility requirements.

How do I verify my medical doctor license in Tennessee?

To request an official verification of your Tennessee license please send your request by e-mail to Medical.Health@tn.gov with the following information: Name, Profession, TN license number, the e-mail or mailing address where the verification should be sent.