Postgraduate Training Licensees

If a resident who is issued a Postgraduate Training License transfers to another program, is terminated, placed on probation/remediation, resigns, takes a leave of absence, or has any other program change that would affect the resident’s anticipated end date of the program, a Program Status Update/Change Form (Form PSU) is required from the program director within 30 days.

If a Postgraduate Training License holder leaves the approved program in which he/she is enrolled to engage in the practice of medicine before the anticipated completion date, a Program Status Update/Change Form (Form PSU) is required from the program director within 30 days. The program director is also required to complete the Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training (Form PTA-PTB).

If the Postgraduate Training License holder transfers to a new program before the anticipated completion date of the approved program, a Postgraduate Training License Enrollment Form (Form EF) is required from the new program director.

• Program Status Update/Change Form
• Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training
• Postgraduate Training License Enrollment Form

Your license could potentially be denied or suspended if it is determined you are either on a delinquent taxpayer list or are delinquent in court-ordered child support payments (Business and Professions Code (BPC) section 31).

Note: The law prohibits the Board from refunding any money paid for the issuance or renewal of a license where the license is denied or suspended (BPC sections 31 and 494.5, and Family Code (FAM) section 17520(e)(3)(D)).

Potential License Denial or Suspension for Failure to Pay Taxes

Potential License Denial or Suspension for Failure to Pay Family Support

The Board may suspend the license/certificate/registration if you are delinquent in court-ordered child support payments and your name appears on the Department of Child Support Service’s (DCSS) “Absent Parent Master File" (BPC section 29.5 and FAM section 17520).

Once it has been determined that you are non-compliant, you will be notified and have 150 days to meet the family support obligation or enter into a payment program with the local child support agency. If you fail to come into compliance, your license will be denied or suspended until the Department of Consumer Affairs receives a release from the DCSS County Child Support Agency Services.

For additional information, please contact the Department of Consumer Affair’s Family Support Program at (916) 574-8018.

Any licensee/registrant with a Current license status may generate a Wallet License at their convenience by accessing the Wallet License Generator.

The Wallet License includes a License Specific QR Code that allows interested parties to instantly view the DCA Search License Profile page with real-time license status information from any QR Code capable device and is generated as an electronic PDF file that can be sent to others as needed.

There is no fee for this service.

All licensees/registrants are required to professionally use the name they are licensed/registered with the Medical Board of California (Board). Using any other name may confuse or mislead the public and may be considered, by the Board, unprofessional conduct.

Any licensee/registrant who wishes to change the professional name under which they practice must complete and submit a Notification of Name Change form to the Board along with required supporting legal documentation.

California law requires each licensee/registrant to report name changes to the Board within 30 days of the name change.

Note: You cannot practice under your middle name when your license is issued with your first, middle, and last name.

No fee is required to process a name change; however, there is a fee to request a duplicate wall certificate with the new name. A new wallet license may be generated by utilizing the Wallet License Generator; there is no fee for this service.

Note: If a licensee/registrant also holds a professional license/registration issued by any of the California Boards and Bureaus listed below, you only need to submit one Notification of Name Change Form to any of the Boards or Bureaus listed. One form will create a name change at each of the Boards and Bureaus listed in which you hold a license/registration.

• Board of Podiatric Medicine
• Board of Registered Nursing
• California Board of Barbering and Cosmetology
• California Board of Behavioral Science
• California Board of Psychology
• Naturopathic Medicine Committee
• Osteopathic Medical Board of California
• Physician Assistant Board
• Respiratory Care Board
• Dental Board of California
• Dental Hygiene Board of California
• Veterinary Medical Board
• Physical Therapy Board
• Board of Optometry
• Board of Vocational Nursing and Psychiatric Technicians
• Board of Occupational Therapy
• Bureau of Security and Investigative Services

If you hold a license/registration with any other California Board or Bureau not listed above, you will need to submit a separate name change form directly to that Board or Bureau.

A wall certificate reflecting the name change will NOT automatically be issued. If you desire a duplicate wall certificate with your new name, you must complete an Application for Duplicate Certificate and submit the appropriate fees. A new wallet license may be generated by utilizing the Wallet License Generator; there is no fee for this service.

At your next renewal, your renewal notice will automatically print with your new name.

Required Documentation:

A current government-issued photographic identification card (e.g., driver license, alien registration, passport, etc.) AND one of the following legal documents as proof of name change:

• Certified Court Order;
• Marriage Certificate, or
• Dissolution of Marriage (Divorce)

Original documents are not required, photocopies will be accepted. If original documents are mailed, they will be returned by certified mail.