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About Us
Office of the Commissioner

Grants

Careers

Reports and Plans
Capital Projects
Programs
Behavioral Health, Alcoholism, and Drug Dependency

Tobacco Resources

Communicable Diseases

Monkeypox

Immunizations

Vaccine for Children Healthcare Providers

Vital Records & Statistics

FEMA COVID-19 Funeral Assistance Program

Women, Infants, and Children

More WIC Information

Nutrition Information

Infant and Toddlers Program

Family Planning Clinics

Maternal and Child Health

Chronic Disease and Prevention

Environmental Health

How To Obtain A Health Card

Public Health Preparedness

Office of Professional Licensure and Health Planning

Emergency Medical Services

Epidemiology & Disease Reporting

Community Health Services

Primary Care

Vector Control Program Projects

Dengue, Zika, and Chikungunya

Dengue Fever

Personal Protection

You Can Help with Mosquito Control!

Contact Us!
News & Events
News

Upcoming Events

Hurricane Preparedness

Hurricanes

Hurricane Season: Are You Ready?

Before a Hurricane

Preparing for a Hurricane: Prescriptions

Preparing for a Hurricane or Tropical Storm

During a Hurricane

Get your family, home, and car ready

Household Cleaning & Sanitizing

Mosquitoes & Hurricanes

Protect Your Pets
Resources
Health Topics

Impacts of Climate Change on Human Health

Forms & Applications

Safe Haven – A Lead-Free Families Initiative

US Virgin Islands

US Government

Coronavirus Disease 2019 (COVID-19)

Tobacco Resources
Contact Us
Alerts and Advisories

Non Discrimination Policy

Tobacco Complaint

Payments

Home » Office of Professional Licensure and Health Planning » Payments

NOTICE: THIS FORM CANNOT BE USED FOR VERIFICATION PAYMENTS

Licensure and Health Planning Payment Form

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Email *

Licensee / Facility Name

License Type *

Other License Type

License Number

(If Applicable)

Payment for:

Certificate of Need - Service
Certificate of Need - Facility
Chiropractic - Application
Chiropractic - Registration
Dental (DDS, DMD) - Registration
Dental (RDH) - Registration
Medical MD/DO - Registration
Medical PA-C - Registration
Optometry - Application
Optometry - Registration
Pharmacist - Application
Pharmacist - Registration
Pharmacy - New
Pharmacy - Change in "Person in Charge"
Pharmacy - Change of Ownership
Pharmacy - Remodeling of Prescription Department
Pharmacy - Non-Resident Pharmacy (Initial)
Pharmacy - Non-Resident Pharmacy (Renewal)
Pharmacy Technician - Certified Pharmacy Technician (CPT)
Pharmacy Technician - Certified Pharmacy Technician w/ Immunization (CPTI)
Pharmacy Technician - Registered Pharmacy Technician (RPT)
Physical Therapy (DPT, PT) - Application
Physical Therapy (DPT, PT) - Registration
Physical Therapy (PTA) - Application
Physical Therapy (PTA) - Registration
Podiatry (PDM) - Application
Podiatry (PDM) - Registration
Veterinary (DVM) - Application
Veterinary (DVM) - Registration
Veterinary Technician - Application
Veterinary Technician - Registration

Fee(s) *

Minimum Price: $15.00

Billing Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Credit Card *

Card Number

Expiration

/

Security Code

To Reduce Health Risks, Increase Access to Quality Healthcare and Enforce Health Standards.

Contact

St. Croix Office
(340) 718-1311
St. Thomas Office
(340) 774-9000
St. John Office
(340) 776-6400

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