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Please enter your credentials (example: DC, CCSP®, DABCI, CPC, etc)

Please do NOT use periods for any credentials

If you do not have any credentials, please enter N/A







Not sure your original date of licensure or your license number?

Lookup the information here: https://oop.ky.gov/lic_search.aspx

If you don't have a license number, put N/A

If an email address is entered into this field, the cc'd email address will receive a copy of all emails that are sent to the email address for this account.

This is NOT required - you can skip this question.




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