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State Medical Board

Applications & Forms

Attention Emergency Courtesy Licensee Applicants!

Effective July 1, 2022 no new ECL applications or ECL Extension applications will be accepted. Expedited temporary licensing is available with the full application process. Please email medicalboard@alaska.gov for more information.

Emergency Courtesy License

Deadline to apply: June 30, 2022

New Emergency Courtesy License applications will not be accepted after July 1, 2022.

Initial Applications

Review the FAQs page for important information about applying for licensure and practicing in the State of Alaska.

Physician (MD, DO, DPM)
Physician Assistant
Renewal Applications

Prior to renewal, check out our License Renewal Prep guide.

If you are a Primary Collaborating Physician for Physician Assistant(s) and/or Sponsor Physician of Mobile Intensive Care Paramedic(s) get a head start by completing these forms prior to renewal.

For your convenience, these forms also available through your MY LICENSE account. Completed forms can be uploaded through MY LICENSE, see the instructions listed below for more details.

Review the FAQ Page for important information about CME requirements for renewals, including the legislative requirement for education in pain management and opioid use and addiction.

Miscellaneous Forms
Division forms may be found in the CBPL Quick links, located in the sidebar to the right.

Licensing Staff Contact Information

Physicians whose last name begins with the letters A through L, and Physician Assistants may contact:
Licensing Examiner: Jason Kaeser
Phone: (907) 465-2781
Email: jason.kaeser@alaska.gov

Physicians whose last name begins with the letters M through Q may contact:
Licensing Examiner: Jacob Olsen
Phone: (907) 465-2566
Email: jacob.olsen@alaska.gov

Physicians whose last name begins with the letters R through Z may contact:
Alisa Perkins
Phone: (907) 465-1077
Email: alisa.perkins@alaska.gov

Medical licensing general contact:
Phone: (907) 269-8163
Email: medicalboard@alaska.gov