Name and Address Changes

Name and address changes may be now submitted online. The name change document (marriage license, section in the divorce decree, etc.) will need to be uploaded to the website. The Board will no longer send out new certificates. You may now print your registration certificate.

A name or address change cannot be taken by phone and must be submitted to the Board's office in writing. If you are unable to use the website to update your information, you may still submitted changes in writing or by email. If you need a license certificate mailed to you, please email the Board office.

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To access the change of name/address form for dental hygienists, please login below.