21 N.C. Admin. Code 16B.1101

Current through Register Vol. 39, No. 9, November 1, 2024

Section 16B .1101 - APPLICATION FOR REINSTATEMENT AND PROOF OF COMPETENCY

(a) Any person desiring to practice dentistry in North Carolina whose North Carolina dental license has been revoked, suspended, retired, or expired shall submit to the Board an application for reinstatement. All applications for reinstatement of a dental license shall be submitted on forms furnished by the Board at www.ncdentalboard.org and shall include:

(1) original dental license number and date of issuance;

(2) full name;

(3) street address as of the date of the application;

(4) telephone number;

(5) email address;

(6) citizenship or immigration status, with verifying documentation;

(7) a statement disclosing and explaining the nature, facts, and disposition of any matter where the applicant has ever:

(A) been summoned to court or before a magistrate for the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(B) been arrested for the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(C) been taken into custody for the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(D) been indicted for the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(E) been convicted or tried for the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(F) been charged with the violation of any law or ordinance or for the commission of any felony or misdemeanor; or

(G) pleaded guilty to the violation of any law or ordinance or for the commission of any felony or misdemeanor;

(8) whether the applicant is under investigation as of the date of the application or has ever been investigated by the Board or any other licensing board;

(9) whether the applicant has ever had a civil lawsuit related to the practice of dentistry settled;

(10) all dental licenses from other jurisdictions ever held by the applicant, including dates of licensure;

(11) a statement disclosing all the applicant's dental practices from dental school graduation to the date of the application, including:

(A) the dates during which the applicant was engaged in practice as a dentist;

(B) the addresses of the offices or places at which the applicant was employed or practicing, and the names and addresses of all employers, partners, associates, or persons sharing office space;

(C) whether the applicant was practicing general dentistry or a specialty; and

(D) the reason for the termination of each employment or period of private practice;

(12) a statement disclosing and explaining any current condition or impairment, including substance abuse, alcohol abuse, or a mental, emotional, or nervous disorder or condition, that in any way affects the ability to practice dentistry. For purposes of this Rule, "current" means recently enough that the condition or impairment may affect the applicant's ability to function as a dentist as set out in G.S. 90-41(a)(2) and (7). If the applicant contends that the condition or impairment is reduced or ameliorated because the applicant is receiving ongoing treatment or participating in a monitoring or support program, the applicant may provide information regarding the treatment or program, and may include any verification demonstrating that the applicant has complied with all provisions and terms of any drug treatment program, or impaired dentists or other impaired professionals program;

(13) two letters of character reference from non-family members;

(14) a copy of a National Practitioner Data Bank report concerning the applicant that was obtained within six months prior to the date the report is submitted to the Board;

(15) documentation of the applicant's completion of continuing education courses, as set out in 21 NCAC 16R .0200, in amounts equal to the number of hours required for renewal of a dental license; and

(16) a copy of an unexpired CPR certificate.

(b) The applicant shall submit to the Board the notarized application form for reinstatement with all the information and materials listed in Paragraph (a) of this Rule, accompanied by the nonrefundable reinstatement application fee set forth in 21 NCAC 16M .0101(a)(8) and the renewal fees set forth in 21 NCAC 16M .0101(a)(2) and (b).

(c) In addition to the requirements of Paragraphs (a) and (b) of this Rule, if the applicant is or has ever been licensed in other states, the applicant shall request the dental regulatory authority or other occupational or professional regulatory authority of each licensing jurisdiction where the applicant holds or has ever held a dental license to send to the Board office, in an unopened envelope sealed by the authority, a certificate of the applicant's licensure status accompanied by a disclosure of any disciplinary action taken or investigation pending.

(d) An applicant whose North Carolina license has been revoked, suspended, retired, or expired for more than one year shall submit to the Board a completed fingerprint record card and signed release of information form authorizing the Board to request a fingerprint-based criminal history record check from the North Carolina State Bureau of Investigation.

(e) An applicant for reinstatement whose North Carolina dental license has been revoked, suspended, retired, or expired for two to five years shall take refresher courses as specified by the Board if the Board determines that the applicant lacks skills or knowledge to practice dentistry. Refresher courses for an applicant whose license was revoked or suspended shall relate to the deficiencies that led to the imposition of discipline. Refresher courses for an applicant whose license has been retired or expired shall be specified by the Board taking into account the amount of time the license has been retired or expired and the applicant's level of experience.

(f) An applicant for reinstatement whose North Carolina dental license has been revoked, suspended, retired, or expired for more than five years shall pass the American Board of Dental Examiners dental licensure clinical examinations before applying for reinstatement.

(g) The Board shall receive all information and documentation set forth in Paragraphs (a) through (e) of this Rule and the applicant's passing scores on any examinations required under Paragraph (f) of this Rule for the application to be complete. Applications that are not completed within one year of being submitted to the Board shall be disregarded as expired without a refund of the application fees.

(h) Any applicant who changes his or her address shall notify the Board office in writing within 10 business days.

(i) Any license obtained through fraud or by any false representation shall be revoked.

21 N.C. Admin. Code 16B .1101

Authority G.S. 90-30; 90-41; 90-42;
Eff. September 1, 2014;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;
Amended Eff. September 1, 2020.

Adopted by North Carolina Register Volume 29, Issue 07 October 1, 2014 effective 9/1/2014.

Amended by North Carolina Register Volume 35, Issue 07, October 1, 2020 effective 9/1/2020.