The board shall issue a certificate to practice direct-entry midwifery to a person who
(1) applies on a form provided by the board;
(2) pays the fees required under AS 08.65.100;
(3) furnishes evidence satisfactory to the board that the person has not engaged in conduct that is a ground for imposing disciplinary sanctions under AS 08.65.110;
(4) furnishes evidence satisfactory to the board that the person has completed a course of study and supervised clinical experience; the study and experience must be of at least one year's duration;
(5) successfully completes the examination required by the board.