Physician Assistant Corporation

TO:  Applicants for Physician Assistant Corporation or Limited Liability Company

ONLY available for those licensed under SDCL 36-4A (Physician Assistant)

Instructions must be followed completely.  The application must be completed in its entirety and submitted with the appropriate fee or it will be returned.

Physician Assistant Corporation or Limited Liability Company Certificate

Documentation CANNOT be faxed or emailed.

  1. Contact Secretary of State and obtain Certificate
  2. Submit to Board office:

NOTE:

  1. Physician Assistant Corporation---must state that all officers, directors, and shareholders are licensed pursuant to SDCL 36-4A.
  2. Limited Liability Company---It must state that all officers, members, and managers are licensed pursuant to SDCL 36-4A.

It is the responsibility of the Physician Assistant Corporation or Limited Liability Company to renew with the renewal fee ($100) on or before December 31 of each year or the Physician Assistant Corporation or Limited Liability Company will automatically forfeit.

Do not rely on notification; use the web site to obtain renewal form.

All applications, fees and above mentioned materials should be sent to:

SD Board of Medical and Osteopathic Examiners
125 S. Main Ave.
Sioux Falls, SD 57104