Changing your name on your MQA Online Services Portal account profile does not change your name on your health care practitioner license. To change your name on your license, you must submit a request and upload the required legal documentation showing the name change. On your MQA Online Services Portal dashboard, select Change of Name from the “Manage My License” pulldown menu and enter your name as it appears on your legal documentation. Attach/upload supporting documents, which must be one of the following:
1. A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court
2. A divorce decree restoring your maiden name
3. A court order showing the name change (adoption, legal name change, federal identity change)
4. A copy of a certificate of naturalization or H1B Employment Visa (Note: Foreign applicants and/or licensees may not have state issued documents)
Any one of these will be accepted unless the department has a question about the authenticity of the document.
NOTE: Please allow 5-7 business days for your request to be processed. If you are requesting a name change outside of renewal and wish to receive a new license reflecting the name change, you must request a duplicate license and pay the $25.00 fee.