Reporting a Name or Address Change
All name and address changes must come in writing to our office. Please include your name, address, social security number, and license or certificate number (if you know it). If you have a name change, you must also enclose a copy of your certificate of marriage, divorce decree, or court order which authorizes the change. You must send this information within 30 days of your change of name or address. Failure to do so, may result in a $100 fine per section 16A DCMR § 3201.1 (d).
There is no fee to record your name or address change if you do not want a revised copy of your license. To receive a new license or certificate reflecting the change, send your request in writing along with a $34.00 duplicate licensee fee. Make your check or money order payable to “DC Treasurer.” Do not send cash.
Please mail your name or address change request to:
Department of Health
Health Professional Licensing Administration
ATTN: Processing Department – Address/Name Change
899 North Capitol Street, NE
Washington DC, 20002
Or fax the request to:
Note: If you want a new license printed, you must mail in your request along with the required check or money order.