Name changes must be submitted in writing by downloading the Data Change/Duplicate License Request Form.  Address changes can be submitted online at www.michigan.gov/mylicense or in writing by downloading the Data Change/Duplicate License Request Form. Fax it to (517) 373-2179 or mail it to the Bureau of Health Professions, PO Box 30670, Lansing, MI 48909.

New licenses are not automatically issued for name and/or address changes. To receive a license with your new name and/or address, you must submit $10.00 per license with your request. Duplicate licenses can be paid for online at www.michigan.gov/mylicense.