Florida

Board

of

Dentistry

Five business days.

1. Certified official court document(s) relative to your criminal record, showing the date(s) and circumstance(s) surrounding your arrest(s)/conviction(s), section(s) of the law violated, and disposition of the case. This would normally consist of the Complaint or Indictment, the Judgment, Docket Sheet or other documents showing the disposition of your case. This may also be referred to as the Order of Probation. The clerk of court must certify these documents.
2. Certified copy of document(s) relative to any disciplinary action taken against any license. The documents must come from the agency that took the disciplinary action and must be certified by that agency.
3. A detailed description of the circumstances surrounding your criminal record or disciplinary action and a thorough description of the rehabilitative changes in your lifestyle since the time of the offense or disciplinary action which would enable you to avoid future occurrences. It would be helpful to include factors in your life, which you feel may have contributed to your crime or disciplinary action, what you have learned about yourself since that time, and the changes you have made that support your rehabilitation.

Yes. After you have successfully logged in, you can modify your password by selecting Update Login located on the side navigational menu.

Once you are logged into Online Services, select Update Address link from the side navigational menu.

Yes, Florida health care professionals can seek assistance for impairment through the Department’s Impaired Practitioner Programs. The program for dentists and dental hygienists is the Professionals Resource Network (PRN). Impairment may be as a result of misuse or abuse of alcohol or drugs, or both, or due to a mental or physical condition which could affect the licensee’s ability to practice with skill and safety.

Professionals Resource Network, Inc. (PRN)
P.O. Box 1020
Fernandina Beach, Florida 32035-1020
Toll Free: (800) 888-8PRN (8776)
Telephone Number: 904-277-8004
Fax: 904-261-3996
E-Mail: admin@flprn.org

Yes, all health care professionals are required to report, in writing within 30 days after you have been convicted or found guilty of, or entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction. You may report the information to:

Department of Health
Board of Dentistry
4052 Bald Cypress Way, #C-08
Tallahassee, FL 32399-3258

Please provide the date of the offense, a description of the allegation and the county and state of jurisdiction. Failing to report is a violation of s. 456.072(1)(x), Florida Statutes.

All medical doctors, osteopathic physicians, chiropractic physicians, podiatrists, and advanced registered nurse practitioners have profiles that list this information.

You are required to report all criminal activities after you receive your license. You may report the criminal offense(s) online via Online Services, by e-mail MQAOnlineService@flhealth.gov, or by mail:

Florida Department of Health
Licensure Support Services Unit, Bin #C-10
Tallahassee, FL 32399-3267

If reporting by e-mail or mail, provide the date of the offense, a description of the crime, and the county and state of jurisdiction.

License Verification – Information regarding the licensure status of a practitioner. This is for use by persons or organizations that do not require a document certifying this information under seal. Licensure Certification – Specific document certifying licensure status and disciplinary history, prepared by a representative of the Division of Medical Quality Assurance and bearing a seal. This document is generally required for applicants seeking licensure in other states and for use in court proceedings. There is a $25 fee for this service in accordance with Rule 64B-4.001, F.A.C.

Print the Complaint Form with the Authorization for Release of Patient Records from our Enforcement site or call 1-888-419-3456 or (850)414-1976 to request one by phone. Complete the form and mail it to the address given on the form.

Each application is evaluated on a case-by-case basis. The board considers the nature, severity, and recency of offenses, as well as rehabilitation and other factors. The board cannot make a determination for approval or denial of licensure without evaluating the entire application and supporting documentation.

You can request a practitioner’s disciplinary history from our Public Records  website under Disciplinary Records.

To view a list of actively licensed practitioners, use the License Verification Search and select the county and profession from the drop-down list.

Users of later versions of AOL may experience problems accessing links within the Medical Quality Assurance (MQA) Services page when inside AOL and using the AOL browser. This is caused by pop-up security features within newer versions of AOL. Try to avoid accessing MQA Services from within AOL. The way around the problem, once you have started AOL, is to minimize the AOL window and, from your computer’s desktop, open up an Internet Explorer or Netscape Navigator browser. Type the url directly on the address line of the browser and press Enter. You will be able to access all the features within the MQA Services page without experiencing problems.

This website is secured using a thawte Digital Certificate. This ensures that all information you send to us via the World Wide Web will be encrypted. Please click on the thawte Trusted Site Seal which demonstrates our commitment to your security. In addition to the thawte Trusted Site Seal, you will also see the “lock” emblem displayed in the browser. In Internet Explorer 6, the lock emblem can be found in the lower right-hand corner of the status bar. In Internet Explorer 7.0, the lock emblem can be found next to the address (URL) line. In FireFox and Netscape, the emblem can be found in both locations.

Login to your MQA Online Services Portal account and select Request Duplicate License from the “Manage My License” pulldown menu. Review your changes and click “Submit.”

NOTE: If your profession is pending renewal or in a current renewal cycle, you may be asked to renew your license instead of being issued a duplicate license.

No. There is no additional cost for making a credit card payment online.

Verify that you are using the email address: MedicalQualityAssurance@doh.state.fl.us Also, If you have SPAM blocker on your computer, you will not be able to receive emails from Licensure Services without updating your SPAM blocker to allow emails from the Department. Please update your SPAM blocker to receive emails from @doh.state.fl.us or contact our Licensure Support Services at (850)-488-0595, for Account ID and Password renewal information.

If a PDF file fails to download, shows up blank, or freezes your internet browser, the file was most likely corrupted during the download process. To correct the problem, you will need to first clear your browser’s cache, then close and restart the browser, which entails logging back into MQA Services to continue downloading the document. If the cache is not cleared the cached version of the document, which is likely damaged, will still appear.

If you are an allopathic physician, osteopathic physician or dentist, licensed in another state but do not hold a Florida medical license, and you plan to provide expert witness testimony in Florida, you must register for an Expert Witness Certificate. If you are interested in becoming an Expert Witness, please register here.

The practice location address will display on the Internet and your license. Your practice location must be a physical location address and must not include a Post Office box. The mailing address will only display on the Internet if you have not provided a practice location address to us.

Board members are appointed by the Governor and confirmed by the Senate. The gubernatorial appointments questionnaire may be obtained at flgov.com/eog/leadership/appointments.

Contact Information for the Governor’s Appointment Office:

Phone: (850 ) 717-9243
Fax: (850) 921-0733
Email: appointments@eog.myflorida.com

A declaratory statement is a means for resolving a controversy or answering questions or doubts concerning the applicability of statutory provisions, rules, or orders over which the board, or department when there is no board, has authority, pursuant to Rule 28-105.001, Florida Administrative Code. A petition for declaratory statement may be used only to resolve questions or doubts as to how the statutes, rule, or order may apply to the petitioner’s particular circumstances. A declaratory statement is not the appropriate means for determining the conduct of another person or for obtaining a policy statement of general applicability. A petition for declaratory statement must describe the potential impact of the statutes, rules, or orders upon the petitioner’s interests.

Declaratory statements can be found at: http://www.floridahealth.gov/licensing-and-regulation/declaratory/declaratory-statements.html

Information  on the requirements and how to file a Declaratory Statement can be found online on the Declaratory Statements page. Please note, a variance or waiver can only be granted for a Board Rule, not a Florida Statute.

Agenda items must be submitted to the Board of Dentistry 30 days prior to any particular Board meeting date. Staff must have sufficient time to review documentation prior to it being placed on the agenda. If, upon review, the application for licensure is found to be complete and requires review by the Board Members, it will be placed on the next available Board Meeting. The application must be complete at least 30 days prior to the Board Meeting date.

For a copy of the current or previous Board Agendas, please visit our Meeting Information page. The current agenda is posted 14 calendar days before the Board Meeting. Previous agendas can be located under Past Meetings.

The minutes from our Board Meetings can be found on our Meetings page.

We encourage you to send as much information as possible to help expedite the licensure process.

The mailing address for documents is:

Department of Health
Board of Dentistry
4052 Bald Cypress Way
Bin# C-08
Tallahassee, FL 32399-3258

All Board meetings are open to the public and you are encouraged to attend. Dentists and dental hygienists may earn up to four hours credit per renewal cycle by attending a meeting of the Board wherein disciplinary cases are considered.

Below are the statutes and rules providing the requirements for requesting a Petition for (Variance from) or (Waiver of) Rule (Citation)

Florida Statutes – 120.542 Variances and waivers

(1)Strict application of uniformly applicable rule requirements can lead to unreasonable, unfair, and unintended results in particular instances. The Legislature finds that it is appropriate in such cases to adopt a procedure for agencies to provide relief to persons subject to regulation. A public employee is not a person subject to regulation under this section for the purpose of petitioning for a variance or waiver to a rule that affects that public employee in his or her capacity as a public employee. Agencies are authorized to grant variances and waivers to requirements of their rules consistent with this section and with rules adopted under the authority of this section. An agency may limit the duration of any grant of a variance or waiver or otherwise impose conditions on the grant only to the extent necessary for the purpose of the underlying statute to be achieved. This section does not authorize agencies to grant variances or waivers to statutes or to rules required by the Federal Government for the agency’s implementation or retention of any federally approved or delegated program, except as allowed by the program or when the variance or waiver is also approved by the appropriate agency of the Federal Government. This section is supplemental to, and does not abrogate, the variance and waiver provisions in any other statute.

(2)Variances and waivers shall be granted when the person subject to the rule demonstrates that the purpose of the underlying statute will be or has been achieved by other means by the person and when application of a rule would create a substantial hardship or would violate principles of fairness. For purposes of this section, “substantial hardship” means a demonstrated economic, technological, legal, or other type of hardship to the person requesting the variance or waiver. For purposes of this section, “principles of fairness” are violated when the literal application of a rule affects a particular person in a manner significantly different from the way it affects other similarly situated persons who are subject to the rule.

(3)The Governor and Cabinet, sitting as the Administration Commission, shall adopt uniform rules of procedure pursuant to the requirements of s. 120.54(5) establishing procedures for granting or denying petitions for variances and waivers. The uniform rules shall include procedures for the granting, denying, or revoking of emergency and temporary variances and waivers. Such provisions may provide for expedited timeframes, waiver of or limited public notice, and limitations on comments on the petition in the case of such temporary or emergency variances and waivers.

(4)Agencies shall advise persons of the remedies available through this section and shall provide copies of this section, the uniform rules on variances and waivers, and, if requested, the underlying statute, to persons who inquire about the possibility of relief from rule requirements.

(5)A person who is subject to regulation by an agency rule may file a petition with that agency, with a copy to the committee, requesting a variance or waiver from the agency’s rule. In addition to any requirements mandated by the uniform rules, each petition shall specify:

(a)The rule from which a variance or waiver is requested.

(b)The type of action requested.

(c)The specific facts that would justify a waiver or variance for the petitioner.

(d)The reason why the variance or the waiver requested would serve the purposes of the underlying statute.

(6)Within 15 days after receipt of a petition for variance or waiver, an agency shall provide notice of the petition to the Department of State, which shall publish notice of the petition in the first available issue of the Florida Administrative Weekly. The notice shall contain the name of the petitioner, the date the petition was filed, the rule number and nature of the rule from which variance or waiver is sought, and an explanation of how a copy of the petition can be obtained. The uniform rules shall provide a means for interested persons to provide comments on the petition.

(7)Except for requests for emergency variances or waivers, within 30 days after receipt of a petition for a variance or waiver, an agency shall review the petition and request submittal of all additional information that the agency is permitted by this section to require. Within 30 days after receipt of such additional information, the agency shall review it and may request only that information needed to clarify the additional information or to answer new questions raised by or directly related to the additional information. If the petitioner asserts that any request for additional information is not authorized by law or by rule of the affected agency, the agency shall proceed, at the petitioner’s written request, to process the petition.

(8)An agency shall grant or deny a petition for variance or waiver within 90 days after receipt of the original petition, the last item of timely requested additional material, or the petitioner’s written request to finish processing the petition. A petition not granted or denied within 90 days after receipt of a completed petition is deemed approved. A copy of the order granting or denying the petition shall be filed with the committee and shall contain a statement of the relevant facts and reasons supporting the agency’s action. The agency shall provide notice of the disposition of the petition to the Department of State, which shall publish the notice in the next available issue of the Florida Administrative Weekly. The notice shall contain the name of the petitioner, the date the petition was filed, the rule number and nature of the rule from which the waiver or variance is sought, a reference to the place and date of publication of the notice of the petition, the date of the order denying or approving the variance or waiver, the general basis for the agency decision, and an explanation of how a copy of the order can be obtained. The agency’s decision to grant or deny the petition shall be supported by competent substantial evidence and is subject to ss. 120.569 and 120.57. Any proceeding pursuant to ss. 120.569 and 120.57 in regard to a variance or waiver shall be limited to the agency action on the request for the variance or waiver, except that a proceeding in regard to a variance or waiver may be consolidated with any other proceeding authorized by this chapter.

(9)Each agency shall maintain a record of the type and disposition of each petition, including temporary or emergency variances and waivers, filed pursuant to this section.

History.—s. 12, ch. 96-159; s. 5, ch. 97-176; s. 37, ch. 2010-102.

Florida Administrative Code (Rules) Chapter 28-104:

Variance OR Waiver
28-104.001 Purpose; Construction.
28-104.002 Petition for Variance or Waiver.
28-104.003 Comments on Petition.
28-104.004 Petition for Emergency Variance or Waiver.
28-104.005 Time for Consideration of Emergency Petition.
28-104.0051 Revocation of Emergency or Temporary Variance or Waiver.
28-104.006 Request for Information.
28-104.001 Purpose; Construction.

This chapter implements Section 120.542, F.S., by establishing the procedures for granting or denying petitions for variances and waivers of agency rules, and, should be read in conjunction with the provisions of Sections 120.52(18), 120.52(19) and 120.542, F.S.

Specific Authority 120.54(5)(b)8., 120.542(3) FS. Law Implemented 120.542(3) FS. History–New 4-1-97, Amended 1-15-07.

28-104.002 Petition for Variance or Waiver.

(1) A petition for a variance from or waiver of an agency rule shall be filed with the clerk of the agency that adopted the rule, with a copy to the Joint Administrative Procedures Committee, Room 120, The Holland Building, Tallahassee, Florida 32399-1300.

(2) The petition must include the following information:

(a) The caption shall read:
Petition for (Variance from) or (Waiver of) Rule (Citation)
(b) The name, address, telephone number, and any facsimile number of the petitioner;
(c) The name, address, telephone number, and any facsimile number of the attorney or qualified representative of the petitioner (if any);
(d) The applicable rule or portion of the rule;
(e) The citation to the statute the rule is implementing;
(f) The type of action requested;
(g) The specific facts that demonstrate a substantial hardship or a violation of principles of fairness that would justify a waiver or variance for the petitioner;
(h) The reason why the variance or the waiver requested would serve the purposes of the underlying statute; and
(i) A statement whether the variance or waiver is permanent or temporary. If the variance or waiver is temporary, the petition shall include the dates indicating the duration of the requested variance or waiver.

(3) The petition for a variance or waiver may be withdrawn by the applicant at any time before final agency action.

(4) Upon receipt of a petition for variance or waiver, the agency shall furnish a copy of the petition to any other agency responsible for implementing the rule.

Specific Authority 120.54(5)(b)6., 120.542(3) FS. Law Implemented 120.542(5) FS. History–New 4-1-97, Amended 3-18-98.

28-104.003 Comments on Petition.

(1) Any interested person or other agency may submit written comments on the petition for a variance or waiver within 14 days after the notice required by Section 120.542(6), F.S. The agency shall state in any order whether comments were received by the agency.

(2) The agency shall maintain the comments as part of the record.

(3) The right to comment pursuant to this section does not alone confer party status in any proceeding arising from a petition for variance or waiver.

Specific Authority 120.54(5)(b)6., 120.542(3) FS. Law Implemented 120.542(6), 120.542(8) FS. History–New 4-1-97.

28-104.004 Petition for Emergency Variance or Waiver.

(1) A person requesting an emergency variance from or waiver of an agency rule shall so state in the caption to the petition.

(2) In addition to the other requirements of Section 120.542(5), F.S., and this chapter, the petition shall specify:

(a) The specific facts that make the situation an emergency; and
(b) The specific facts to show that the petitioner will suffer an immediate adverse effect unless the variance or waiver is issued more expeditiously than the time frames provided in Section 120.542, F.S.
Specific Authority 120.54(5)(b)6., 120.542(3) FS. Law Implemented 120.542(3), (5) FS. History–New 4-1-97.

28-104.005 Time for Consideration of Emergency Petition.

(1) The agency shall grant or deny a petition for emergency variance or waiver within 30 days of its receipt by the agency. If such petition is not granted or denied within this time limit, the petition shall be deemed approved unless the time limit is waived by the petitioner.

(2) Within 5 days after filing a petition for emergency variance or waiver with the agency clerk, the agency shall give notice of receipt of the petition on its website, if it has one. The agency shall also give notice by any procedure that is fair under the circumstances or provide notice of the petition to the Department of State for publication in the first available issue of the Florida Administrative Weekly. Any notice under this subsection shall inform interested persons of the right to submit comments. Interested persons or other agencies may submit written comments on the petition for emergency variance or waiver within 5 days after publication of the notice required herein. The notice and comment requirements in this subsection shall not apply if the agency head finds that an immediate danger to the public health, safety, or welfare requires an immediate final order, which final order shall recite with particularity the facts underlying such finding.

(3) If the agency decides that the situation is not an emergency, the petition shall then be reviewed by the agency on a non-emergency basis as set forth in Section 120.542(7), F.S.

(4) The duration of an emergency variance or waiver shall be determined by the agency.
(5) The agency shall issue a written order granting or denying the petition. The order shall state the facts and reasons supporting the agency’s action.
Specific Authority 120.54(5)(b)8., 120.542(3) FS. Law Implemented 120.542(3) FS. History–New 4-1-97, Amended 1-15-07, 12-24-07.

28-104.0051 Revocation of Emergency or Temporary Variance or Waiver.

(1) Upon receipt of evidence sufficient to show that the recipient of an order granting an emergency or temporary variance or waiver is not in compliance with the requirements of that order, the agency shall issue an order to show cause why the emergency variance or waiver should not be revoked.

(2) The recipient of an emergency or temporary variance or waiver shall respond to the order to show cause why the emergency variance or waiver should not be revoked within 15 days of the mailing date of the order to show cause. Failure to timely respond shall result in a final order revoking the emergency or temporary variance or waiver.

Specific Authority 120.54(5)(b)6. FS. Law Implemented 120.542(1), (3) FS. History–New 3-18-98.

28-104.006 Request for Information.

(1) When a person inquires of the agency about the possibility of relief from any rule requirements or the remedies available pursuant to Section 120.542, F.S., the agency shall provide the information required by Section 120.542(4), F.S., within 15 days of the inquiry.

(2) In its response to a request for information, the agency shall indicate the name and address of the appropriate contact person for additional information and shall indicate how a petition for variance or waiver is filed with the agency.

Specific Authority 120.54(5)(b)6., 120.542(3) FS. Law Implemented 120.542(4) FS. History–New 4-1-97.

Please contact the DEA at (954) 306-5345 or visit their website www.deadiversion.usdoj.gov.

According to Rule 64B5-17.002(2), FAC : A dentist shall maintain the written dental record for a period of at least four years from the date the patient was last examined or treated by the dentist. Malpractice or HIPPA laws may require a longer retention.

Yes. Rule 64B5-17.009, F.A.C. allows patients or their legal representative to receive copies of all reports and records, including x-rays. A dentist shall comply with a patient’s written request for copies of records and reports in a timely manner, with due regard for the patient’s health needs. In the absence of circumstances beyond the control of the licensee, timely shall mean less than 30 days.

Yes. A dentist may charge a fee for copying reports or records not to exceed the cost per page charged by the Clerk of the County Court where the dentist practices. The fee for copies of x-rays shall not exceed actual cost of duplication. Payment of copying fees may be required upon delivery of the copies.

A complaint may be filed with the Consumer Services Unit.

Yes, disciplinary information on all healthcare professions and establishments regulated by MQA are included in the License Lookup search system. Please see our List of Regulated Professions for assistance in locating the profession you are seeking.

All convictions, guilty pleas, and nolo contendere pleas must be reported, except for minor traffic violations not related to the use of drugs or alcohol. This includes misdemeanors, felonies, “driving while intoxicated (DWI)” and “driving under the influence (DUI).” Crimes must be reported even if they are a suspended imposition of sentence. All prior disciplinary action against any other professional licenses must be reported, whether it occurred in Florida or another state or territory.

You must submit a signed request in writing. Mail your request to:

Board of Dentistry
4052 Bald Cypress Way
Bin #C08
Tallahassee, Florida 32399-3258

You may also fax your request to (850) 921-5389.