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Physician Assistant (PA) License Application

Physician Assistant (PA) License Application

For applicants seeking a Physician Assistant license in Mississippi. PA practice is conducted under physician supervision.

At a glance: A PA license authorizes practice as a physician assistant in Mississippi under physician supervision. Submitted online through MELS (Mississippi Enforcement and Licensure System).

Education requirement: Master’s level education from an accredited program required.

Fee: $550, payable after submission. View full fee schedule.

License validity: Issued before March 31 expires June 30 of current year; on or after April 1 expires June 30 of following year.

Renewal: Annually.

Important rules before you start

Online Application Timeline. Your online application stays active for 90 days from the date the Board receives each verification from an outside institution. Each new verification received resets the 90-day window, up to a maximum of 365 days total from the date of submission. If the application is not completed and the license is not issued within 365 days, the application will be considered null and void, and a new application must be submitted along with all required fees and certifications. The 365-day time limit cannot be waived under any circumstances.

Application Progress. Once submitted, applicants may track progress through MELS (Mississippi Enforcement and Licensure System).

Incomplete Application Fee. A one-time $50.00 fee will be assessed if MSBML staff discover during application review that the application is not complete. This includes, but is not limited to: any public record not disclosed on the application (for example, prior name changes or prior arrests), or unreported segments of training (for example, training completed in part at one facility and in part at another must list both facilities and the time spent at each).

Refund Policy. No refunds will be issued under any circumstances.

Items Submitted by the Applicant

Submit these items upon completion of the online application and fees.

PDFPhysician Assistant Licensure Application InstructionsReference · Print and use as a checklist
ABirth Certificate or PassportCertified or notarized copy. If your name differs from your birth certificate, submit supporting documents (legal name change, marriage certificate, divorce decree, etc.). See Notary Guidelines and Form.
BPhysician Assistant School DiplomaCopy of the original. If diploma does not indicate graduation from a PA studies program, the school must submit an official transcript directly to the Board.
CDriver’s LicenseCopy of current license. Uploaded online during the application.
DTranslated Foreign Language DocumentsCertified English translation by a recognized translator. See Notary Guidelines and Form for accepted notarized copy formats. U.S. PA programs may submit original and translated PA school diplomas on behalf of an applicant.
PDFE. Affidavit and Perpetual Release FormSigned and notarized. The ORIGINAL must be mailed to the Board. A copy must be included with each hospital privilege form sent to a hospital.
GPhotograph (physical and electronic)Passport-type photo taken within the last 60 days, in two forms: (1) physical wallet-sized print attached to the Affidavit, and (2) electronic copy uploaded via MELS. See Photograph Guidelines.
HApplicant FingerprintsTwo options: (1) FD-258 fingerprint cards mailed by the Board to your address, or obtained from a local law enforcement agency or fingerprinting service provider, completed and returned to the Board; or (2) LiveScan at MSBML, scheduled by the Board after application review and approval. See Fingerprinting Options.

Verifications Requested by the Applicant (Primary Source)

The following verifications must be sent directly from the issuing institution to the Board.

PDFAppendix A (Education Certification)Primary source · Sent by each PA school attendedPDFAppendix C (Activity Certification)Primary source · All activities since PA school. Each activity for past 5 years must be verified.PDFAppendix D (Interstate Licensure Certification)Primary source · Each state in which you hold or have held a PA license. VeriDoc accepted.PDFAppendix E (Staff Membership Certification)Primary source · Hospital or staffing privileges held within the past 5 years.

Examination and Credential Reports

  • NCCPA Examination Report: Request from nccpa.net to be sent directly to the Board.
  • Military Records: DD-214 Form for any military service.

How to Apply

  1. Register in MELS

    First-time applicants create a username and password in MELS.

  2. Request your primary source verifications

    Send Appendix A, C, D, and E (as applicable) to each issuing institution. Request NCCPA Examination Report.

  3. Complete and submit the online application

    Log in to MELS, complete each section, upload documents, and pay the application fee.

  4. Mail your Affidavit and physical items

    Mail the ORIGINAL notarized Affidavit and Perpetual Release Form (with wallet-sized photo attached) and completed fingerprint cards to the Board.

  5. Track your application in MELS

    Track progress in MELS.

Fee

$550, payable after submission. No refunds. A one-time $50.00 incomplete-application fee may be assessed.

For the full breakdown of all MSBML licensing fees, see the Fee Schedule.

Questions?

Email mboard@msbml.ms.gov. Subject line: License Type + Applicant’s Full Name. By phone: 601.987.3079.

Ready to apply?

Have your forms ready, then start your application in MELS.

← Back to Apply

Mississippi Administrative Code: For complete rules governing this license type, see Mississippi Administrative Code, Part 2615 (Physician Assistant rules) on our Laws, Code & Policies page.