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Volunteer License Application

Volunteer License Application

For retired or military physicians, osteopathic physicians, and physician assistants who wish to donate their expertise for the medical care and treatment of indigent and needy persons or persons in medically underserved areas of Mississippi.

At a glance: A Special Volunteer Medical License is issued to physicians or physician assistants who are retired from active practice, currently serving on active duty in the Armed Forces of the United States or the National Guard or a reserve component of the Armed Forces, or working as physicians or physician assistants for the Department of Veterans Affairs.

Fee: No application fee, examination fee, license fee, or renewal fee per Mississippi Law (§73-25-18). View full fee schedule.

License validity: Issued for a fiscal year or part thereof.

Renewal: Annually upon approval of the Board.

Important rules before you start

Eligibility commitment. Volunteer license holders must commit to donating their expertise without compensation for the medical care and treatment of indigent and needy persons or persons in medically underserved areas of the state.

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

No Fees. Per Mississippi Law (§73-25-18), the special volunteer medical license shall be issued without payment of any application fee, examination fee, license fee, or renewal fee. The license shall be issued for a fiscal year or part thereof and shall be renewable annually upon approval of the Board.

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

Board Approval. The license is issued at the discretion of the Board upon verification that the applicant meets all eligibility requirements.

Items Submitted by the Applicant

The online application requires the applicant to upload the following documents. Download the application instructions PDF below to use as a reference.

PDFVolunteer Licensure ApplicationReference · Print and use as a checklist
PDFAffidavit and ReleaseSigned and notarized.
2Foreign Language DocumentsIf applicable. Must be translated into English and certified by a recognized translator.
3Electronic PhotographIn format documented in the MSBML Photograph Guidelines.
4Military Documentation (if applicable)A letter from the commanding officer for active military, or a letter from a supervisor at the Department of Veterans Affairs.

Verifications Provided by Third Parties (Primary Source)

The following verifications must be sent directly from the applicable institution to MSBML.

PDFAppendix A (Education Certification)Primary source · Completed by each medical school attended.PDFAppendix C (Activity Certification)Primary source · Completed by applicable institution for each activity completed since medical school within the past 5 years.PDFAppendix D (State Medical Board Licensure Certification)Primary source · Licensure certification from each other state where applicant holds or has held a license.

How to Apply

  1. Confirm eligibility

    Confirm you are retired from active practice, currently active-duty military, or working with the Department of Veterans Affairs.

  2. Register in MELS

    Create a username and password in MELS (Mississippi Enforcement and Licensure System).

  3. Complete and submit the online application

    Upload all applicant-side documents. No application fee is charged.

  4. Request primary source verifications

    Request Appendix A (education), Appendix C (activity), and Appendix D (state licensure) be sent directly to MSBML.

Fee

No application fee, examination fee, license fee, or renewal fee per Mississippi Law (§73-25-18).

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 (general MSBML rules) on our Laws, Code & Policies page.