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Dietitians & Nutritionists

Applications and Forms


    Click Here to Renew Online    

For licenses expiring December 31, 2017, online renewal is available until September 15, 2019.

NOTE:   Valid license numbers may or
may not include four alpha characters.
If you have an alpha-numeric license number, you must enter all characters
in order to renew online.

EXAMPLE:   ABCD1234


Renewal Forms

Paper renewal forms will be available November 9, 2017.


Initial License Applications

  • Application for Dietitian License, #08-4400, Revised 12/10/15. Must also provide verification of registration from the Commission on Dietitian Registration.
  • Application for Nutritionist License, #08-4399, Revised 12/10/15. Must also provide verification of registration from the Certification Board for Nutritional Specialists or provide proof of a masters degree in human nutrition and 900 hours of experience in the field

Miscellaneous Forms