Arizona Administrative Code
Title 4 - PROFESSIONS AND OCCUPATIONS
Chapter 20 - BOARD OF DISPENSING OPTICIANS
Article 1 - GENERAL
Section R4-20-107 - Application for a Dispensing Optician's License by Comity
Universal Citation: AZ Admin Code R 4-20-107
Current through Register Vol. 30, No. 38, September 20, 2024
An applicant for a dispensing optician's license by comity shall submit an application packet to the Board that contains:
1. An application form provided by the Board, signed and dated by the applicant that contains:
a. The applicant's name, Social Security
number, address, and telephone number;
b. The applicant is dispensing optician
license number and the state and date of licensure;
c. A statement of whether the applicant has
ever been convicted of a felony or of a misdemeanor involving moral turpitude
in any state;
d. A statement of
whether the applicant has ever been denied a license or had a license suspended
or revoked in any state; and
e. A
sworn statement by the applicant verifying the truthfulness of the information
provided by the applicant;
2. A photocopy of the unexpired license and a written statement, signed by an officer of the Board that issued the license, that states the license is in good standing, and that the license is valid to dispense both eyeglasses and contact lenses;
3. A photograph of the applicant taken not more than six months before the date of application; and
4. The fee required in R4-20-112.
Disclaimer: These regulations may not be the most recent version. Arizona may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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