11/13/2024
FORGOT USERNAME / PASSWORD
The email entered on this screen is only used to send you the current username and/or password. Changing your email address on this screen will only update where the system sends the requested username and/or password. Please use the menu option ‘Record Correction (Name, Address, Phone & Email)’ to update your Name, Address, Phone and/or Email for each license you hold.
User Type:
Provider ID
 
Email:
Board Name:
Last Name:
First Name:
Email

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