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DIETETIC LICENSURE BOARD 

DIETETIC LICENSURE FORMS

Dietetic Licensing Staff: (A-L) Jodi Adcock and (M-Z) Claudia Lawson

PLEASE NOTE: Should your license be issued to you on or before March 30, you will be required to renew by June 30 of that year. If you do not receive a license until after that date, you will not be required to renew until June of the following year.

No practice is permitted prior to receipt of a license number.  

Applicants are advised not to enter irrevocable contracts, purchase or sales agreements, on the assumption that licensure will be granted.


Initial Licensure Application Forms:
     Application for Initial Licensure
Provisional Licensure Application Forms (Non-Registered Applicants)
     Application for Provisional Licensure

**Processing time for an application is dependent on the Applicant and proper submission of the application with the required documentation.