Public Information and Records Request Home Public Information And Records Request Public Information and Records Request Requester Information First name Last Name Email Email Confirm email Phone Number Records Request If you need a list of licensee information for marketing or commercial requests, please fill out the Records Reproduction Request Form. If you need a license verification for moving out of state, please see our website. If you are checking on your application or have a general question about your license or renewing, please fill out the General Questions form. Request Description Attachment(s) Upload Please attach any additional information that would help us process your request.Unlimited number of files can be uploaded to this field.100 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. CAPTCHA Get new captcha! What code is in the image? Enter the characters shown in the image. Submit Leave this field blank