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Update Contact Information

NAME and/or ADDRESS CHANGES

ADDRESS CHANGES

Every record at the Division contains two addresses:

  1. Address of Record: This is the address that appears on your license/registration and is your business/public record address. You must have an address of record on file. If you do not provide an address of record, your mailing address will be used as the address of record.
  2. Mailing Address: This is the address used by the Board and Division staff to send correspondence to you. This address is not a public record unless you do not provide a public record address.

If you have moved or changed either your Address of Record or your Mailing Address, you should notify the Division as soon as possible by filling out the Name/Address Change Affidavit and submitting it to the Division OR by updating the information ONLINE.

If you prefer to submit changes to your address offline, please mail a signed, written request to the Board of Medicine, PO Box 83720, Boise, Idaho 83720-0063

PHONE NUMBER & E-MAIL ADDRESS

The Division also maintains business phone numbers and e-mail addresses for those who wish to provide them. The business phone number you provide will be part of your public record. The e-mail address you provide will be used by the Board and Division staff to send correspondence to you. Your e-mail address is not a public record.

There is no fee required to update any of the contact information.

INDIVIDUAL NAME CHANGES

The individual name that appears on your license/registration must be your legal name. If it is not, you need to update your record by filling out a Name/Address Change Affidavit and submitting it with the proper documentation (i.e., a marriage license, divorce decree, or court document noting name change) to the Division.

UPDATING YOUR LICENSE

** You will not receive a copy of your license/registration bearing the updated information until the next renewal period unless you submit the name change form along with the required documentation prior to renewing online.

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