X
GO

Request a Name Change

A licensee shall notify the board of a name change within 30 days of the change. Please keep in mind this is public information. Please print, complete, and return the Application for Name Change located at the link below. Include a copy of the legal document that changed your name. (Examples include a court order, marriage certificate, or dissolution of marriage decree.) Return both documents by mail to Bureau of Professional Licensure, 321 E. 12th St., Des Moines, IA, 50319; by fax to 515-281- 3121; or by email to PLPublic@idph.iowa.gov Note: A name change request can take between 24-72 hours to complete; please do not request documents from the office until the name change is complete.  You can verify the change has occurred by accessing the online services page located at https://IBPLicense.iowa.gov/

If you would like to receive a new licensure card and/or license certificate due to the name change, the $20.00 fee for each document is required. This can be done by accessing the online services page located at https://IBPLicense.iowa.gov/

Establishments can change the name of their establishment ONLY as long as the ownership and/or location has not changed. If an establishment has an ownership and/or address change, a new license application is required. This can be done by accessing the online services page located at