Birth month licensure request 2026

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  1. Click ‘Get Form’ to open the birth month licensure request in the editor.
  2. Begin by selecting your preference for licensing. Check one of the options provided: either to wait until your birth month or to be licensed immediately, acknowledging that your initial license will be valid for less than a 24-month term.
  3. Fill in your printed name as it appears on Form L1A in the designated field.
  4. If known, enter your ATS# in the appropriate section.
  5. Provide your date of birth in the format mm/dd/yyyy.
  6. Sign and date the form at the bottom to confirm your application.
  7. Once completed, choose a submission method: submit with your initial application, fax it to (916) 263-2487, or mail it to the specified address.

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Fastest State Medical Licenses #1 - Colorado Medical Board. The Colorado Medical Board is able to issue a Physician Medical License within 30 days of filing an Expedited Medical License application. # 2 - Ohio Medical Board. # 3 - New York Medical Board. # 4 - Indiana Medical Board. # 5 - Michigan Medical Board.
Online renewal is available at .breeze.ca.gov Make check, money order, or cashiers check in the amount of $318 payable to the Physician Assistant Board. Mail renewal application and fees to the Physician Assistant Board at the address listed above 30 days prior to the license expiration date.

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