2012 Physician Renewal Application

State regulation requires all physicians currently practicing in the state to renew their license by March 1, 2012 and pay the $150.00 registration fee in order to keep their license active.  Renewals paid after March 1, 2012 but prior to the April 1, 2012 deadline, may be made by paying an additional $50.00 penalty fee.  Failure to renew your license by April 1, 2012 deadline will cause your license to automatically become inactive and subsequent practice in Kentucky will be considered the unauthorized practice of medicine. 

You will be required to report CME compliance on this renewal application.  The CME cycle you will be reporting began January 1, 2009 and ended December 31, 2011.  If you would like to review the CME requirements, please visit the Board's CME page or contact Patty Wacker at (502) 429-7150 extension 236.  If you need to request a six-month extension to complete your CME requirements, you will have the opportunity to do so when renewing your license.  The fee to request a CME extension will be $100.00.

To begin your renewal, please read the instructions below and click on the 2012 On-Line Renewal Application link below.

• You will be prompted to enter a user name and password on the left side of the page once you click on the link below.
• Your username is your Kentucky license number and your password is the last four digits of your social security number.  Do not create a new profile at the login screen.  Log in using your Kentucky license number and last four digits of your social security number.
• You will see a screen welcoming you.  Click on Click Here to Renew Your License next to the License Renewal Information section.
• To begin processing your information, click on the link Click Here To Renew License.
• Once your information has been completed, you will be prompted to pay using either a credit card or ACH debit.  The payment screen is a pop up window.  Please make certain your browser allows pop up windows.
• You will have the ability to print a temporary wallet card and payment receipt upon completion of payment.

  2012 Online Renewal Application (Please make certain you have read the instructions above before proceeding with your renewal.  Log in using your Kentucky license number and last four digits of your social security number.)

The 2012 Physician Renewal Application is available to be printed and mailed to the Board.  Should you choose to renew your license by paper, there will be an additional charge of $10.00

2012 Paper Application  (PDF 48KB)