Division of Professions and Occupations: Update Contact Information

Address Change Information for Individual Licenses

Individuals may change their address online using the Division's Online Services address change.

Address Change Information for Business/Entity Licenses

Businesses/Entities may not change their address online and must submit an Address/Name Change Request

Please note that this form may not be used to change the name or address of an entity registered with the Board of Pharmacy. Please visit the Pharmacy Applications and Forms page for Pharmacy modification forms.

Name Change Information

All licensees wishing to change their name with the Division must complete a Name Change Request Form.

DO NOT SEND ORIGINALS. A copy of one of the following must accompany all Name Change Request Forms for individuals: 

  • Marriage License
  • Divorce Decree
  • Court Order

Affidavit of Social Security

All applicants who do not have a Social Security Number must complete an Affidavit of Social Security.