Every record at the Board contains 2 addresses.
- Address of Record: This is the address that appears on your license/registration and ispublic record.
- Confidential Address: This address is not public record.
Licensees have the option of selecting either one as their mailing address.
Any change in your address of record or your mailing address can be reported to the Board by updating the information online or mailing a signed, written request. If you have moved or otherwise changed one or both of these addresses since your last license/registration was issued, you must notify the Board as soon as possible.
The Board also maintains business phone numbers and e-mail addresses for those that wish to provide them. The business phone number you provide will be part of your public record. The e-mail address you provide may be used by the Board to send correspondence to you. This e-mail address is not a public record. These may also be updated online.
There is no fee required to update any of the contact information in your Board record. If you wish to have a license re-printed to reflect the address changes you have made, a fee of $10.00 is required.
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
11341 W. Chinden Blvd.
Boise, ID 83714
E-mail, phone, fax
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 in your Division record.
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 (ie. A marriage license, divorce decree, or court document noting name change) to the Division.
NOTE: You cannot change the name of your business or the legal structure of your business with this form. Changes to the name of your business or the legal structure of your business may require you to reapply. Please contact the Division prior to the expiration date of your license/registration if you have changed the name or structure of your business.
** You will not receive a 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.