Create New eServices User Account

This information is strictly confidential and Occupations and Professions uses Secured Sockets Layer (SSL) and 128-bit encryption for online data transmissions.

Your eServices Account Information
Username     (Must be between 8-15 alpha numeric characters in length)
Password    (Must be between 8-15 alpha numeric characters in length, should have at least 1 number)
Verify Password  
UserType  (Select the appropriate type of user from the list)
Security Question
Your Contact Information
First Name   Middle Name/Initial Last Name  
Suffix Name SSN or OP ID      
Telephone     Extension
E-mail Address       (Enter a valid E-mail address)
If you opt to use the OP ID and have not received correspondence with your OP ID number, please contact the Department of Professional Licensing at (502) 564-3296.