Please note that an application fee only extends an initial license to the next renewal date. Initial licenses do vary in duration. It is the responsibility of all licensees to renew their license before expiration. Failure to renew shall result in automatic forfeiture or suspension of the license by statute. Licenses which have forfeited are not automatically entitled to renew.

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Non-Physician Online Account Request Form

Completing and submitting this form is the first step in the process. You will soon receive an email with your "Username" and "Password" and instructions so that you may login to the Board's website to submit the online application. Please note these forms are processed in the order received and may take up to 7 business days.

An online "to-do-list" is created after review of your submitted application.

South Dakota Administrative Rules 20:78:03:02 and 20:78:03:03 require that your application process be completed within 120 days from the date that you submitted your application. You will be informed by email if you are approaching the 120 day limit for application completion.

Must provide full Legal name
Must provide full Legal name
Provide your full middle name - No Initials.
Must provide complete physical street home address including city, state and zip code.
Must be applicant's personal or work email address.
(Spouses of Active Duty Military Personnel ONLY): 1.) I hold the same or similar valid license, certificate, registration, or permit required for the practice of any business, profession, or occupation issued by another state or the District of Columbia. 2.) My spouse is a member of the armed forces of the United States. 3.) My spouse is the subject of a military transfer to South Dakota. 4.) I left employment to accompany my spouse to South Dakota.
An authorized agent can be anyone that you would like to have access to your online account and be able to openly discuss your application file with Board Staff. If you mark yes - an additional form will be emailed to you and will require your signature to add the authorized agents to your online account.
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
1 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.