Arizona Administrative Code
Title 4 - PROFESSIONS AND OCCUPATIONS
Chapter 21 - BOARD OF OPTOMETRY
Article 2 - LICENSING PROVISIONS
Section R4-21-202 - Licensure by Endorsement
Universal Citation: AZ Admin Code R 4-21-202
Current through Register Vol. 30, No. 52, December 27, 2024
A. An individual is eligible to apply for licensure by endorsement if the individual:
1. Graduated from an accredited optometry
program;
2. Is licensed to practice
the profession of optometry in another state that has licensing requirements
that the Board determines meet or exceed Arizona's requirements;
3. Has engaged in the practice of the
profession of optometry continuously in the other state or military for at
least four of the five years before the date of application; and
4. Has not had a license to practice the
profession of optometry suspended or revoked by any licensing jurisdiction for
a cause that is a ground for suspension or revocation of a license in
Arizona.
B. To apply for licensure by endorsement, an individual who is eligible under subsection (A) shall submit the application form described in R4-21-201(B).
C. In addition to complying with subsection (B), an applicant for licensure by endorsement shall submit or have submitted on the applicant's behalf:
1. The materials
required under
R4-21-201(C)(1) through
(C)(4) and (C)(6) through (C)(10);
2. A state board certification and license
verification form, which is submitted directly to the Board from the state that
issued the license on which the applicant's endorsement application is based,
indicating:
a. Name and title of the
individual completing the verification form;
b. Applicant's optometry license number in
the state;
c. Date on which the
applicant was issued an optometry license by the state;
d. A statement of whether the applicant:
i. Has been licensed in the state for at
least four of the last five years;
ii. Is certified to use topical diagnostic,
topical therapeutic, or oral pharmaceutical agents and if so, the date on which
the certification was obtained;
iii.
Is currently in good standing in the state;
iv. Is known to be licensed to practice the
profession of optometry in another state and if so, the name of the other
state;
v. Has been subject to any
disciplinary action and if so, the date, nature of, and reason for the
disciplinary action; and
vi. Is
subject to any pending investigation or complaint and if so, the nature of the
investigation or complaint; and
e. The dated, notarized signature of the
individual completing the verification form; and
3. A letter on official letterhead, in
substantially the form provided by the Board, from a representative of the
accredited optometry program at the educational institution from which the
applicant graduated, providing details that demonstrate the applicant's
education meets the standards at
R4-21-207;
and
4. If the applicant does not
meet the requirements listed in
R4-21-201
or
R4-21-202(A)(2),
a current certificate issued by the CELMO or its successor
organization.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.