Name changes require legal documentation showing the name change. Please submit a request including your full name as it appears on your license, profession, license number, your new name, your date of birth, the last four digits of your social security number, and your signature. Attach supporting documents, which must be one of the following:
- a copy of a state issued marriage license that includes the original signature and seal from the clerk of the court
- a divorce decree restoring your maiden name
- a court order showing the name change (adoption, legal name change, federal identity change)Any one of these will be accepted unless the Department has a question about the authenticity of the document. A social security card is not considered legal documentation.
Any one of these changes will be accepted unless the Department has a question about the authenticity of the document. A social security card is not considered legal documentation.
The Division of Medical Quality Assurance is now issuing electronic licenses, which enables you to download a PDF copy of your license within two business days. The license can be retrieved in the License Documents menu of your MQA Online Services Portal, https://mqa-vo.doh.state.fl.us/datamart/voservicesportal account. To learn more, please visit the electronic licensing webpage at https://flhealthsource.gov/electronic-licensing/.
If you need to change your name, and you prefer to renew online, please submit your name change request by mail and allow 5-7 business days processing time before you renew online.
