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Board of Medicine Address
  Commonwealth of Massachusetts
  Board of Registration in Medicine
  200 Harvard Mill Square, Suite 330
  Wakefield, MA 01880
  (781) 876-8200
  (781) 876-8395 (TTY)
  Hours M-F; 8:45 a.m. to 5:00 p.m.

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Home > Physician Information > Reactivate from Retirement

Downloadable Application
Kit for
Reactivation from Retirement

Please read the instructions carefully before completing your application.

Reactivation from Retirement

Reactivation from Retirement Kit Adobe Acrobat Document
Reactivation from Retirement Letter Adobe Acrobat Document
Instructions Adobe Acrobat Document
Application Checklist Adobe Acrobat Document
Application Adobe Acrobat Document
Authorization for Release Adobe Acrobat Document
Medicare Tax Form Adobe Acrobat Document
Supplement Instructions Adobe Acrobat Document
Malpractice History  Adobe Acrobat Document
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