NEW COSMETIC LASER REGISTRANTS OR FACILITIES WITH CHANGE OF OWNERSHIP
*Certified Laser Operators must currently meet A.A.C. Requirements-R12-1-1438.01 (est. Page 225) andA.R.S. §32-3233 and A.R.S. §32-516.
**Fees will be $47.00 for each Laser head device.
You will need to provide all the above to complete the process of your application. Do not leave any blank spaces, incomplete forms will be returned.
CURRENT REGISTRANTS THAT WANT TO RENEW, CHANGE FACILITY NAME, OR CHANGE ADDRESS
CURRENT REGISTRANTS THAT WANT TO MAKE AN AMENDMENT TO THEIR REGISTRATIONS, (ADD/REMOVE UNITS, OR CHANGE OF MEDICAL DIRECTOR OR LSO)
If change in Medical Director and/or LSO, please also submit the following: