(a) The applicant shall provide the Board and attest to, or provide the means to obtain and verify, the following information and documentation in a manner required by the Board:
(1) the applicant's full name and all aliases or other names ever used, current address, Social Security number and date and place of birth;
(2) a recent signed photograph and, at the board's discretion, other documentation of identity;
(3) originals of all documents and credentials required by the Board, or notarized photocopies or other verification acceptable to the Board of such documents and credentials;
(4) a list of all jurisdictions, United States or foreign, in which the applicant is licensed or has applied for licensure to practice medicine or is authorized or has applied for authorization to practice medicine;
(5) a list of all jurisdictions, United States or foreign, in which the applicant has been denied licensure or authorization to practice medicine or has voluntarily surrendered a license or an authorization to practice medicine;
(6) a list of all sanctions, judgments, awards, settlements or convictions against the applicant in any jurisdiction, United States or foreign.
(7) a detailed educational history, including places, institutions, dates and program descriptions of all his or her education beginning with secondary schooling and including all college, pre-professional, professional and professional postgraduate education;
(8) a detailed chronological life history, including places and dates of residence, employment and military service, United States or foreign; and
(9) all Web sites associated with the applicant's practice; and
(10) any other information or documentation the Board determines necessary.
(b) The applicant shall possess the degree of Doctor of Medicine or Osteopathy from a medical college or school located in the United States, its territories or possessions or Canada that was approved by the Board or by a private nonprofit accrediting body approved by the Board at the time the degree was conferred. No person who graduated from a medical school that was not so approved at the time of graduation shall be examined for licensure or be licensed in this jurisdiction.
(c) The applicant must be twenty-one years of age or over;
(d) The applicant must have satisfactorily completed a postgraduate medical training program approved by the Board or by a private nonprofit accrediting body approved by the Board in an institution in the United States, its territories or possessions or Canada approved by the Board or by a private nonprofit accrediting body approved by the Board. The program must be at least thirty-six (36) months.
(e) The applicant must have passed medical licensing examination(s) satisfactory to the Board.
(f) The applicant must have demonstrated a familiarity with the statutes and regulations of the jurisdiction relating to the practice of medicine and the appropriate use of controlled or dangerous substances.
(g) The applicant must be physically, mentally and professionally capable of practicing medicine in a manner acceptable to the Board and shall be required to submit to a physical, mental, professional competency or chemical dependency examination(s) or evaluation(s), if deemed necessary by the Board.
(h) The applicant must not have been found guilty by a competent authority, United States or foreign, of any conduct that would constitute grounds for disciplinary action under the regulations of the Board or the act. The Board may, at its discretion, modify this restriction for cause, but it shall use such discretionary authority in a consistent manner.
(i) The applicant must make a personal appearance before the Board or a representative thereof for interview, examination or review of credentials. At the discretion of the Board, the applicant may be required to present his original medical education credentials for inspection at the time of personal appearance.
(j) The applicant shall be held responsible for verifying to the satisfaction of the Board the validity of all credentials required for his medical licensure. The Board shall verify medical licensure credentials directly from primary sources and utilize recognized national physician information services (e.g., the Federation of State Medical Boards' Board Action Data Bank and Credentials Verification Service, the files of the American Medical Association and the American Osteopathic Association, and other national data banks and information resources).
(k) The applicant must pay all fees and complete and attest to the accuracy of all application and information forms required by the Board. The Board shall require the applicant to authorize the Board to investigate and/or verify any information provided to it on the licensure application.
(l) Applicants must satisfactorily pass a criminal background check.