Rules & Regulations of the State of Tennessee
Title 1130 - Board of Physician Assistants
Chapter 1130-02 - General Rules Governing the Practice of an Orthopedic Physician Assistant (Transferred from 0880-10)
Section 1130-02-.17 - CHANGE OF ADDRESS AND/OR NAME

(1) Change of Address - Each person holding a license who has had a change of address or place of employment, shall file in writing with the board his/her current address, giving both old and new addresses. Such requests shall be received in the Committee's Administrative Office no later than 30 days after such change is effective and must reference the individual's name, profession, social security number, and license number.

(2) Change of Name - An individual registered with the Committee shall notify the Committee in writing within 30 days of a name change and will provide both the old and new names. A request for name change must also include a copy of the official document involved and reference the individual's profession, board, social security, and license numbers.