MD/DO Administrative Licensure
- An administrative medical license allows the licensee to engage in professional, managerial, or administrative activities related to the practice of medicine or the delivery of health care services, but does not include nor permit the practice of clinical medicine or the right to engage in medical research. The applicant is required to provide a notarized statement which indicates that he or she will not provide medical or clinical services to or for patients while in possession of an administrative medical license.
- The cost of the license application is $550, which is payable after the submission of an online application. The license is valid until June 30th of the current renewal year. However, if the license is issued after April 1, it is valid until June 30th of the following year.
Applying for a License
- All license applications are submitted online utilizing the Mississippi Enforcement and Licensure System (MELS). First time users must register and establish a Username and Password. Click the link below to access the user Gateway:
Instructions and Forms
Please do not send these forms to MSBML without first submitting an application for licensure via the MELS User Gateway.
- Application Instructions
- Affidavit and Release Form
- Administrative Statement
- Appendix A - Med School Certification Form
- Appendix B - Post Graduate Certification Form
- Appendix C - Activity Certification Form
- Appendix D - State Medical Board Certification Form
- Appendix E - Staff Membership Certification Form
- Appendix F - Fifth Pathway Certification
- Notary Guide and Form
- Photograph Guidelines
- Fingerprinting Guidelines
Renewing a License
Administrative licenses must be renewed annually. Click the link below for renewal instructions: