21 NCAC 16F .0105          APPLICATION FOR RENEWAL or reinstATEMENT

(a)  The certificate of registration shall be renewed each year based on the anniversary of the date of issuance. Within 30 days after the anniversary date, the professional entity shall submit its application for renewal upon a form available on the Board's website, www.ncdentalboard.org, and shall include the following information:

(1)           name of the company as shown on the certificate of registration;

(2)           name of the company as of the date of the application for renewal, if the company name has been amended;

(3)           street address of the company;

(4)           mailing address of the company, if different from the street address;

(5)           email address of the company;

(6)           name, address, and dental license number of each shareholder or member, and each dentist practicing under the company;

(7)           name, address, and occupation of each corporation director and officer, or each limited liability company manager; and

(8)           disclosure of any disciplinary action taken by, or investigation pending before, the Board with respect to any licensed dentist identified as an incorporator, officer, director, shareholder, member, manager, or employee.

(b)  The application shall be submitted by the president or vice president of the professional corporation or association or by a manager of the professional limited liability company to the Board with all the information listed in Paragraph (a) of this Rule, accompanied by the renewal fee of twenty-five dollars ($25.00).

(c)  If the application for renewal of the certificate of registration is not submitted within 30 days after the anniversary of the date of issuance, the certificate of registration shall be suspended. The professional entity may apply for reinstatement of the certificate of registration by satisfying the requirements of Paragraphs (a) and (b) of this Rule including payment of the renewal fee, plus payment of the penalty fee of ten dollars ($10.00) as set out in G.S. 55B-11.

History Note:        Authority G.S. 55B‑11; 57D-2-01; 57D-2-02; 90‑48;

Eff. September 3, 1976;

Readopted Eff. September 26, 1977;

Amended Eff. April 1, 1994; May 1, 1989;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;

Amended Eff. July 1, 2022; September 1, 2020.