Sec. 4. An application for renewal must be verified by the applicant and include the following information:
(1) Any action taken against the podiatrist for conduct that would be a ground for disciplinary action.
(2) Any awards, judgments, or settlements against the podiatrist that total at least twenty thousand dollars ($20,000) in a calendar year.
(3) The podiatrist's voluntary surrender or voluntary limitation on a license or authorization to practice podiatric medicine in another jurisdiction.
(4) Any denial to issue the podiatrist a license or authorization to practice medicine in another jurisdiction.
(5) The podiatrist's voluntary resignation from the medical staff of a health care institution or voluntary limitation of the podiatrist's staff privileges at the health care institution if the action occurred while the podiatrist was under investigation by the health care institution for possible medical incompetence, unprofessional conduct, or a mental or physical impairment.
(6) The podiatrist's voluntary resignation or withdrawal from a podiatric medical society, an association, or an organization if the action occurred while the podiatrist was under investigation or review by the medical body for possible medical incompetence, unprofessional conduct, or a mental or physical impairment.
(7) Any addiction or treatment for addiction to alcohol or a chemical substance during the preceding two (2) years.
(8) Any physical injury or disease or mental illness during the preceding two (2) years that affected or may affect the podiatrist's ability to practice podiatric medicine.
(9) Except for a showing of good cause that is acceptable to the board, evidence of the podiatrist's maintenance of professional medical competence, which may include continuing podiatric medical education, postgraduate studies, institutes, seminars, lectures, conferences, work shops, professional evaluation, and specialty board certification or recertification during the preceding four (4) years.
As added by P.L.33-1993, SEC.64. Amended by P.L.180-2018, SEC.41.