Information Update:

Name and Contact Information Update:
If you need to update your name or contact information, please complete and submit the Information Update Form. The Information Update Form may be submitted by email to Carolyn Martin at carolynkm@health.ok.gov, by fax to (405) 271-1918, or by mail to OSDH-PCL, 1000 NE 10th St., Oklahoma City, OK 73117.

Use the link below to obtain the Information Update Form:

• Information Update Form

Email Address Update:
If you need to update your email address only, use the link below to send your request to the Department by email to Eric Ashmore at erica@health.ok.gov. 
Please include your name, license type, and license number in your request Do not change the information in the subject line.

• Update My Email Address

Please note, by submitting your email address to the Department you may receive correspondence from the Department as necessary.