Verification Form

Request for License Verification:

Requests for verification of Louisiana license must be made in writing by providing the verification form provided by the state requesting the verification, providing the contact name and mailing address to return the completed verification to, and submission of the license verification fee or $15 (per LAC 46:XXXIV.801.A.6) for each verification requested.

    1. If the state requiring the license verification has a standard license verification form, complete portion of form for licensee and sign if applicable; then scan for upload submission.
  2. HAVE PAYMENT TOOLS AVAILABLE and ready, such as credit card or bank account information for e-check payments; $15 license verification fee required.
  3. ENTER THE LOUISIANA LICENSE NUMBER below for the verification. PLEASE CHECK NAME OF THE LICENSEE that is provided on the form that comes up to verify the correct Louisiana license number was provided. No fee refunds for incorrect submissions.
  4. COMPLETE the license verification request form.
  5. PRINT a copy of the completed license verification change form for your records BEFORE submitting the form.

To submit a request for license verification electronically with electronic fee payment by credit card or echeck enter the license number below and click “Next”. Please have the verification form ready to upload as well as your payment method available.

License Number: