(a) Complete and swear to an application furnished by the board accompanied by a non-refundable fee of $150, and file this with the Executive Officer of the Board. Applicant will be required to take the Kansas Optometry Law portion at the annual exam. If taking the law exam a different time other than at the annual exam, there will be an additional $75.00 fee to schedule a time in the Board office.
(b) Advise the board if he or she has ever been the subject of a disciplinary action or, within the preceding 24 months, been the subject of an investigation or proceeding that could lead to disciplinary action by any state professional licensing authority.
(c) Provide sufficient proof that the applicant:
(1) is a graduate of an accredited school or college of optometry,
(2) has never had his or her license to practice optometry revoked,
(3) has never surrendered his or her license to practice optometry as a result of disciplinary action by any state professional licensing authority,
(d) Provide verification from current State Board that the license is in good standing.