- A restricted temporary license shall entitle the physician to practice medicine only within the confines of an ACGME or AOA approved postgraduate training program in this state. The cost of the license application is $50, which may be tendered at the completion of the application process. If issued after April 1, the license is valid until June 30 of the following year.
- Applications for a restricted temporary license cannot be submitted until three (3) months prior to the applicant's postgraduate training program start date.
Applying for a license
- All license applications are submitted online utilizing the Mississippi Enforcement and Licensure System (MELS). First time users must register and establish a Username and Password. Click the link below to access the user Gateway:
Instructions and Forms
Please do not send these forms to MSBML without first submitting an application for licensure via the MELS User Gateway.
- Application Instructions
- Affidavit and Release form
- Appendix A - Med school certification form
- Appendix B - Post Graduate certification form
- Appendix C - Activity certification form
- Appendix D - State Medical Board certification form
- Appendix E - Staff membership certification form
- Appendix F - Fifth Pathway certification form
- Notary guide and form
- Photograph guidelines