Before applying for licensure, please familiarize yourself with the general licensing policies.
An applicant for reinstatement of a Connecticut license that has lapsed due to nonrenewal shall arrange for the submission of the following documentation directly from the source:
A completed, notarized application with photo and fee in the amount of $190.00 in the form of a bank check or money order payable to, “Treasurer, State of Connecticut”;
The applicant’s current curriculum vitae (CV) or synopsis of professional activity since completion of the applicant's physician assistant educational program;
Official verification, sent directly from the National Commission on Certification of Physician Assistants (NCCPA) to this Department, of certification status;
If applicable, official verification form sent directly from each state licensing authority where a license or certification is or has ever been held, and
Verification from the appropriate authority confirming the applicant's most recent employment; including dates and overall evaluation of your ability to practice with reasonable skill and safety.
Note: Typically, applicants for reinstatement who have not been in active, clinical practice for longer than five years are required to complete a period of refresher training or pass an examination. Applicants will receive further information from the Department upon receipt of all required documentation.
Please arrange for all supporting documentation to be sent directly from the source to:
Connecticut Department of Public Health
Physician Assistant Licensure
410 Capitol Ave., MS# 12 APP
P.O. Box 340308
Hartford, CT 06134
Phone: (860) 509-7603
Fax: (860) 707-1931