An applicant for reinstatement of a license that has lapsed due to nonrenewal shall provide the following documentation:
A completed, notarized application with photograph and fee in the amount of $565.00 in the form of a bank check or money order payable to, "Treasurer, State of Connecticut";
A current curriculum vitae (CV) including a synopsis of professional activity since completion of professional education;
Verification of any out-of-state license or certification held, current or expired, submitted directly to this office from the source. Please contact the jurisdiction prior to submitting the form as some require a fee for this service;
Verification from the appropriate authority confirming the applicant's most recent employment as an optometrist; including dates and an overall evaluation of the applicant's ability to practice with reasonable skill and safety. If in private practice, a letter from another practitioner with whom the applicant has a referral relationship indicating the dates of the referral relationship and an evaluation of the applicant's ability to practice with reasonable skill and safety.
Verification of successful completion of twenty contact hours of continuing education within the one-year period immediately preceding the application for reinstatement.
Applications submitted from optometrists who have been out of active, clinical practice are presented to the Connecticut Board of Examiners for Optometrists for recommendation as to the applicant's suitability for reinstatement. The board meets quarterly. Applicants to whom this applies will receive further information from the Department upon receipt of an application.
All supporting documentation should be submitted from the source to:
Connecticut Department of Public Health
410 Capitol Ave., MS# 12 APP
P.O. Box 340308
Hartford, CT 06134
Phone: (860) 509-7603
Fax: (860) 707-1931