Reinstatement of a Lapsed License

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:

 

Applications are only accepted online.  In order to submit your reinstatement application online, you will need to know your current user ID and password in DPH's system.  If you do not recall your user ID and password, you can use the recovery options as well as the 'Register' link.  If you use the 'Register' link, please disregard the language under 'PLEASE READ' and select 'NEXT' button at the bottom of the page.  On the next screen, you will need to match your first name, last name and the last 4 digits of your SSN and create a new password and validate your email address.  Once you are logged in, select 'Reinstatement Application' at the bottom left corner of the screen.  Please select this link to submit your online application.

 

As part of the application, you will upload your current curriculum vitae (CV) including a synopsis of professional activity since completion of medical school and verification of completion of 25 hours of continuing medical education (CME) within the one year period immediately preceding application for reinstatement;

 

Verification of any out-of-state licenses held, current or expired, submitted directly to this office from the source.  Please contact the jurisdiction prior to making a request as some jurisdictions charge a fee for completion of the form;

 

Verification from the appropriate authority confirming the applicant's most recent clinical employment,  including dates and overall evaluation of the applicant's ability to practice medicine with reasonable skill and safety.  If the applicant is in private practice, a letter from another physician with whom the applicant has referred patients.  Such letter shall indicate dates of the employment or referral relationship, the title of the applicant, duties performed and if the applicant is in good standing.  This letter needs to be submitted directly to DPH from the source.

 

Note: Applicants for reinstatement who have not been in the active, clinical practice of medicine for longer than six (6) months are reviewed by the Connecticut Medical Examining Board.  The CMEB meets on the third Tuesday of the each month.   

 

All supporting documents should be sent by fax or email directly from the source to:

 

Connecticut Department of Public Health

Physician Licensure

410 Capitol Ave., MS# 12 APP

P.O. Box 340308

Hartford, CT 06134

Phone:  (860) 509-7603

Fax:  (860) 707-1931

email:  dph.healingarts@ct.gov