Section 630.290 - Application for license1. An application for licensure as a physician assistant must be made on a form supplied by the Board. The application must state:(a) The date and place of the applicant's birth and his or her sex;(b) The applicant's postsecondary education as a physician assistant, including, without limitation, postsecondary institutions attended, the length of time in attendance at each and whether he or she is a graduate of those schools and institutions;(c) Whether the applicant has ever applied for a license or certificate as a physician assistant in another state and, if so, when and where and the results of his or her application;(d) The applicant's work experience for the 5 years immediately preceding the date of his or her application;(e) Whether the applicant has ever been investigated for misconduct as a physician assistant or had a license or certificate as a physician assistant revoked, modified, limited or suspended or whether any disciplinary action or proceedings have ever been instituted against the applicant by a licensing body in any jurisdiction;(f) Whether the applicant has ever been arrested for, investigated for, charged with, convicted of or pled guilty or nolo contendere to:(1) Any offense or violation of any federal, state or local law, including, without limitation, the laws of any foreign country, which is a misdemeanor, gross misdemeanor, felony or similar offense in a foreign jurisdiction, excluding a minor traffic offense; or(2) Any violation of the Uniform Code of Military Justice;(g) Whether the applicant has ever been arrested for, investigated for, charged with, convicted of or pled guilty or nolo contendere to any offense which is related to the manufacture, distribution, prescribing or dispensing of controlled substances;(h) Whether the applicant has an untreated medical condition that may affect his or her ability to practice as a physician assistant; and(i) A public address and the mailing address at which the applicant prefers to receive correspondence from the Board.2. An applicant must submit to the Board: (a) Proof of completion of an educational program as a physician assistant:(1) If the applicant completed the educational program on or before December 31, 2001, which was approved by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Programs; or(2) If the applicant completed the educational program on or after January 1, 2002, which is accredited by the Accreditation Review Commission on Education for the Physician Assistant or approved by the Commission on Accreditation of Allied Health Education Programs;(b) Proof of passage of the examination given by the National Commission on Certification of Physician Assistants; and(c) Such further evidence and other documents or proof of qualifications as required by the Board.3. Each application must be signed by the applicant and accompanied by a signed affidavit indicating that: (a) The applicant is the person named in the proof of completion of an educational program as a physician assistant required by subsection 2;(b) The proof of completion of the educational program required by subsection 2 was obtained without fraud or misrepresentation or any mistake of which the applicant is aware; and(c) All the information contained in the application and any accompanying material is complete and correct.4. The application must be accompanied by the applicable fee.5. An applicant shall pay the reasonable costs of any examination required for licensure.Nev. Admin. Code § 630.290
Bd. of Medical Exam'rs, §630.290, eff. 12-20-79-NAC A 6-23-86; 9-12-91; 1-13-94; 11-3-95; 7-18-96; R149-97, 3-30-98; R007-99, eff. 9-27-99; R108-01, 11-29-2001; R145-03, 12-16-2003; A by R171-20A, eff. 6/2/2023; A by R068-23A, eff. 8/23/2024