Section R9-16-106. Name Change; Duplicate License

A.      To request a name change on a midwifery license or a dupli- cate midwifery license, a midwife shall submit in writing to the Department:

1.        The midwife’s name on the current midwifery license;

2.        If applicable, the midwife’s new name;

3.        The  midwife’s  address,  license  number,  and  e-mail address;

4.        As applicable:

a.         Documentation   supporting   the   midwife’s  name change, or

b.        A statement that the midwife is requesting a dupli- cate midwifery license; and

5.        A non-refundable fee of $10.00.

B.       Upon receipt of the written request required in subsection (A), the Department shall issue, as applicable:

1.        An amended midwifery license that incorporates the name change but retains the expiration date of the mid- wifery license, or

2.        A duplicate midwifery license.

Historical Note

Adopted effective March 14, 1994 (Supp. 94-1). Section R9-16-106 renumbered to R9-16-108; new Section R9- 16-106 made by exempt rulemaking at 19 A.A.R. 1805,

effective July 1, 2013 (Supp. 13-2).