If you will be away from your computer for any period of time after starting your online application, it is strongly advised that you click on the "Save for Later" button located at the bottom of each page to minimize the risk of losing the application data that you have already input into the system. You can then log back into the application at a later time by clicking on "Continue Saved Application" located in the New Applicants section.
Note: For healthcare staffing firms or others facilitating this application for the applicant, please provide your contact information.
Federation of State Medical Boards' Credentialing Verification Service
FCVS is a service of the Federation of State Medical Boards that, for a fee, provides primary source verification of core credentials for physicians applying for a medical license. It is accepted, but not required, by the North Dakota Board of Medicine. For further information about FCVS, click here.
Military Service
Military Orders
Biographical Information
Other Names Used
Please use the Add button below to list additional names used. Add
Contact Information
You must indicate both a home address and a business address. If you do not have a business address, please indicate your home address in both sections.
Business Address
Home Address
Mail Preference
Email Preference
User Account Information
Create a user account with a username and password to use in accessing your saved application and online services.
Create Password
Enter and confirm your password.
Passwords must be at least 8 (eight) characters in length and include at least 1 (one) uppercase letter, lowercase letter, number and special character.Special characters allowed are @ ! $ % & * ( ) - [ ] { } , / : ?