Facility Renewal for 2022 State of Nevada Board of Veterinary Medical ...

ATTENTION: THE RENEWAL PROCESS IS CHANGING.

THIS YEAR WILL BE A TRANSITION YEAR TO A NEW RENEWAL SCHEDULE.

FOR 2021, LICENSES WILL BE ISSUED FOR 18 MONTHS AND WILL NOT EXPIRE UNTIL JUNE 30, 2023

WHEN YOU RENEW YOUR LICENSE IN 2023, IT WILL BE ISSUED FOR 2 YEARS

YOUR CE REQUIREMENTS WILL NOT CHANGE FOR YOUR RENEWAL IN 2021 OR 2023

PLEASE SEE THE CHARTS BELOW FOR REFERENCE TO THE SCHEDULE OF CHANGES

MAKE SURE TO UPDATE YOUR EMAIL WITH OUR OFFICE THROUGH OUR NEW LICENSEE PORTAL AT NVVETBOARD.

License Type

Prior Fee Fee 2021 Fee 2023

DVM-Diplomate $250 Active

DVM/Diplomate $130 Inactive

LVT

$75

$375

$500

$195

$260

$112.50 $150

ET

$100

$150

$200

License Type DVM-Dip Active LVT APT AC EDP

2021 20 10 5 15 8

2023 20 10 5 15 8

APT

$25

$37.50 $50

AC

$25

$37.50 $50

FAC (Non-profit) $100

$150

$200

FAC (DVM Owned)

FAC (Non-DVM Owner)

Mobile

$100 $300 $50

$150 $450 $75

$200 $600 $100

2025 40 20 10 30 16

Remit To:

State of Nevada Board of Veterinary Medical Examiners

4600 Kietzke Lane, Bldg. O, #265, Reno, NV 89502 (775) 688-1788 phone / (775) 688-1808 fax

Website- E-mail-mail@vetboard.

2022 Nevada Facility License Renewal

Owned by a NV licensed veterinarian - $150.00 Non-Profit - $150.00

Mobile facility- $75.00

FEES

Owned by a non-veterinarian/non-NV Licensed DVM - $450.00 Late Fee $50.00 a month after 12/31/2021

**Renewals must be received in the Board office prior to 12/31/2021 or the late fee will apply** GENERAL INFORMATION

E-mail address - Within 48 hours you will receive an email confirmation/receipt for this renewal which may be printed for your records.

Name of Facility

Veterinarian-in-Charge

Owner

Facility License Number

There are no changes to the address or phone numbers on record with the Board.

Facility Address

City

State

Zip

Telephone Number

Fax Number

NEVADA BUSINESS LICENSE

NRS 353C requires all licensing boards to provide the following information to the State Controller's Office: X I have a Nevada business license number assigned by the Nevada Secretary of State upon compliance with the

Provisions of Chapter NRS 76. My Nevada business license number is:

I do NOT have a Nevada business license number.

FOR OFFICE USE ONLY

Date of Check:

Check Number:

Amount: $

Initials:

GLS

Excel

Emailed

STATEMENT OF RESPONSIBILITY

I,

veterinarian in charge, hereby acknowledge and understand that I as the

veterinarian-in-charge of said facility may be responsible for any violations of the Nevada Veterinary Practice Act

(NRS/NAC 638) that may occur in said facility.

I further acknowledge and understand that I may be named in any action taken by the Nevada State Board of Veterinary

Medical Examiners against this facility.

I further acknowledge and understand that the veterinarian-in-charge cannot require or permit the veterinarian(s) in said

facility to violate any provision of any local, state, or federal laws or regulations pertaining to the practice of veterinary

medicine or operation of a facility in Nevada.

I further acknowledge and understand that upon the change of the veterinarian-in-charge of the facility, a self-inspection

of the facility shall be performed jointly by the departing veterinarian-in-charge and the new veterinarian-in-charge.

Date

Signature of veterinarian-in-charge

LICENSED PERSONNEL

Veterinarian-in-Charge:_ Owner (s): Veterinarians

Veterinary Technicians

Veterinary Technicians in Training Attach List if Needed

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