Division of Professions and Occupations: Update Contact Information
Individuals may change their address online using the Division's Online Services address change.
Business/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.
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
All applicants who do not have a Social Security Number must complete an Affidavit of Social Security.