INSTRUCTIONS FOR GRADUATES OF
U.S. AND INTERNATIONAL OSTEOPATHIC SCHOOLS
PERMANENT LICENSURE
For D.O. applicants who have passed all required COMLEX Exams
If you have passed all three levels of the COMLEX exams and wish to apply for permanent licensure in Illinois there are two applications and several supporting documents required.
Four page Illinois Permanent License Application:
1. Application Transmittal Checklist
Physician form which MUST be sent as the cover sheet with the application and documents.
2. Print out and complete 4-page application with BLACK ink only
On page 1:
#1 Professional Name = PHYSICIAN/SURGEON
#2 Professional Code = 036
#3 License Method =
“ENDORSEMENT” if you are permanently licensed in another state OR
“ACCEPTANCE OF EXAMINATION” if you have completed all 3 COMLEX exams.
#4 Application Fee = $300.00 (check payable to “IDFPR”)
On page 3, Part V:
Be sure to list all attempts of USMLE exams, National Boards, Osteopathic Boards, or FLEX taken,
including failures.
3.$300.00 - in the form of a check or money order made payable to the Department of
Professional and Financial Regulations (“IDFPR”).
4. Copy of original medical school diploma. If your medical school diploma is written in a language other than English, you are required to provide an original translation of the document.
5. Original, official transcripts from undergraduate school(s) (showing at least 2 years of premedical
education) with school seal affixed.
6. Official transcripts from medical school (showing 2 years of study in basic medical sciences
and 2 years core clinical clerkships) with school seal affixed.
7. VE-PCForm
You must account for your activities for the past five (5) years to include employment both medical and non-medically related. If you were in medical school during that time, please include that information. List your most recent employment (your residency) first.
8. TN-MED Form
Proof of 24 months, at a minimum, of satisfactory completion of clinical training in an approved training facility within the U.S. or Canada. This form cannot be signed any earlier then 15 days before the completion of the 24 months. An Institutional SEAL must be affixed. If requesting from an institution other than Loyola and a seal is not available, the signature MUST be notarized, and a letter on the program/institutional letterhead stating no seal exists attached.
9. CT Form – Certification of Licensure
The CT form is to be completed ONLYIF you have EVER held/hold a permanent license in any state or country. Complete the top half of the form and send it to each appropriate licensing agency. The document must be completed by the jurisdiction of original licensure and the jurisdiction where you have most recently been practicing. This applies to individuals licensed in a U.S. jurisdiction or foreign country or province. Please direct the licensing entity to return the completed form directly to you so that it is included with your application packet. This can be faxed TO the agency, but an original with seal must be mailed back.
NOTE: Some states charge for this service. Call or check online to verify so you may include payment with your request to facilitate a quick turnaround.
10. If you have married, divorced, or legally changed your name for another reason, you must provide the legal documents verifying the name change.
11. State Controlled Substances Registration Application
While you are in training you may use the institution’s number. However, if you wish to have your own Federal DEA number, you will need to complete this application. The Illinois State Controlled
Substances License is required in order to be eligible to apply for a Federal DEA number, or
to use your current Federal DEA number in Illinois.
Please complete both pages of the Application
List Loyola University Medical Center as your business address
- 2160 S. First Avenue
- Bldg 102 Room 2649
- Maywood, IL 60153
Circle all drug schedule options
Attach appropriate fee, a separate $5 check
Return to your Training Program Coordinator with your license application.
Once you receive your Controlled Substances License, you may apply for your Federal DEA on the
DEA website:
Proof of Examination Transcript Request Application
Request the NBOME to forward an official transcript of your pass/fail examination history Levels/Parts 1 – 3 directly to:
Illinois Dept. of Professional & Financial Regulations
The Medical Licensing Unit
320 W. Washington
Springfield, IL 62786
(Phone 217.782.8556)
You may print out the transcript form at
Permanent licenses are issued in the name of the applicant and are mailed directly to theapplicant's home address as indicated on the application.
You must provide GME with a copy of your license when you receive it. It may be brought directly to the office or faxed to the GME office at 708-216-5446. You may not begin your program until the GME office has a copy of your license. Duration of current permanent licenses is on a 3-year cycle. You must renew your license and provide an update copy to the GME office upon issuance. See IDFPR website for additional information on licensure renewals.
Questions? Call your Training Program Coordinator.
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