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State Medical Board of Ohio









physician general licensure information

licensee profile & status

on-line change of address

on-line verification form

Treatment & compliance programs

Treatment Providers

A licensee seeking treatment for chemical dependency, either self-identified, or identified by another source, may be required to seek an evaluation and subsequent treatment with a Board-approved treatment provider. To that end, the Board reviews the treatment provider's Application for Good Standing to determine whether the provider meets the requirements set forth in section 4731-16-08, Ohio Administrative Code. A Certificate of Good Standing is subsequently reviewed every three years to determine continued compliance.

List of Chemical Dependency Assessors

List of Psychiatric Assessors

List of Approved Treatment Providers

CME courses for licensees who have been directed by the Board to seek continuing medical education in a specific area

Certificate of Good Standing as a Treatment Provider for Impaired Physicians

Renewal of Good Standing as a Treatment Provider for Impaired Physicians


The compliance section is responsible for monitoring board licensees who are subject to the terms and conditions set forth in Board Orders or Consent Agreements.

The various forms needed for compliance can be found in the links below.

Alcohol & Drug Rehabilitation Attendance Log

Declaration of Compliance

Instructions on How to Submit Specimens

Log of Controlled Substances Prescribed, Administered, Dispensed

Physician Assistant Prescribing Log

Board Appearances & Probationary Office Conferences

List of scheduled Board appearances and probationary office conferences for the current month

board staff liaisons

Danielle Bickers, Compliance Supervisor

ph: (614) 644-9085

fx: (614) 728-5946

Annette Jones, Compliance Officer

ph: (614) 728-4641

fx: (614) 728-5946






licensee profile & status
treatment and compliance  
position statements
Coroner's Reporting form
medical board public records policy
professional guidelines
Ohio revised code
Ohio administrative code


30 East Broad Street, 3rd Floor, Columbus, Ohio 43215-6127 | Telephone: (614) 466-3934 | Fax: (614) 728-5946
Complaint Forms: (800) 554-7717 | Licensure Verification: (800) 357-7720