A. A person may
apply to the board for the termination of the suspension or reissuance of a
revoked license. Pursuant to A.R.S. §
32-1551,
the board shall make its determination on each application as it deems
consistent with the public health, safety and just in the circumstances. The
applicant must provide the Board with;
1. A
completed application form, provided by the Board that is signed, dated, and
verified; which shall include the following information;
a. Applicant's full name and any former names
used by the applicant;
b. Place and
date of birth;
c. Social Security
number;
d. Home, business, and
e-mail addresses;
e. Home,
business, and cell phone numbers;
f. A completed Arizona Statement of
Citizenship and Alien Status for State Public Benefits, and copy of
evidence;
g. The name of the
approved naturopathic college applicant graduated from, date of graduation, and
date of clinical training completion;
h. Documentation showing that the basis for
the suspension or revocation has been removed, and that suspension termination
or reinstatement of the license or certificate, does not constitute a threat to
the public health or safety;
i. A
list of all license or certificates issued or denied by any agency. Applicant
must cause to have a document submitted directly to the Board from each agency
listed, containing the applicant's name, date of issuance or denial, current
status and whether or not any disciplinary actions are pending or have ever
been taken;
j. Whether applicant
has ever been arrested, charged with, convicted of, or entered into a plea of
no contest to a felony or a misdemeanor;
k. Whether applicant has ever had a
naturopathic medical license or certification, or any other health profession
license or certification denied, suspended, rejected or revoked by any
agency;
l. Whether applicant has
ever been disciplined by any agency for any act of unprofessional conduct as
defined in A.R.S. §
32-1501;
m. Whether in lieu of disciplinary action,
has applicant ever entered into a consent agreement or stipulation with a
licensing agency;
n. Whether
applicant currently has an open complaint or is involved in any open
investigation in any agency or court of law, in any state or territory of the
United States;
o. Whether applicant
has ever had the authority to prescribe, dispense, or administer a natural
substance, drug, or device limited, restricted, modified, denied, surrendered
or revoked by a federal or state agency or court of law;
p. Whether applicant has ever been found
medically incompetent;
q. Whether
applicant has ever been a defendant in any malpractice matter that resulted in
a settlement or judgment;
r.
Whether applicant has a medical condition that in any way impairs or limits
applicant's ability to practice medicine, and;
s. A detailed explanation and supporting
documentation for each affirmative answer to questions regarding the
applicant's background;
2. A complete and legible fingerprint card,
including the DPS processing fee;
3. A passport size photograph taken within 60
days prior to application submission that is signed on the back by the
applicant, and;
4. The fees
specified in
R4-18-107;
5. Proof of completion of 30 hours of CME for
each year the license has been suspended or revoked. The CME is in addition to
the 30 hours required each year for license renewal, must cover clinical
application of naturopathic medical philosophy and pharmacology, and, be
accredited by the Accreditation Council on Continuing Education, or approved by
any of the programs listed in
R4-18-205(B)(2);