Fictitious Name Permit
Fictitious Name Permit Applications
- Application for Cancellation of a Fictitious Name Permit
- Fictitious Name Permit Application
- Fictitious Name Permit – Change of Address Form
- Fictitious Name Permit – Notification of Renewal/Hold Release
- Fictitious Name Permit – Notification of Partnership Change
- Fictitious Name Permit – Notification of Shareholder Change
- Application for a Duplicate Fictitious Name Permit
Common Reasons for Rejection of Fictitious Name Permits
The Medical Board of California receives approximately 1,225 Fictitious Name Permit (FNP) applications per year. The process can be time-consuming because of the volume and because applicants frequently may not read or follow instructions provided on the application.
To assure timely service, the Medical Board is asking physicians and their attorneys to take the time to carefully review and complete the application. Some of the common errors that applicants make on the application are:
- The signature block on the application is not complete. Every portion of the signature block must be completed and include an original signature. Be sure to fill in the entire date upon which the application is being signed. Only original and complete applications will be accepted.
- The desired name is already taken or is too similar to existing names. To check for name availability, click on the Fictitious Name Permit Search link below. Reservations for names will not be accepted.
- The fictitious name does not comply with the statutory requirements. The name cannot be deceptive, misleading, confusing (B & P Code section 2415(b)(3)) or similar to a name previously issued. (CCR 1350.3)
- If applying as an individual (sole proprietor), the Social Security Number or Individual Taxpayer Identification Number is not listed. If applying as a partnership, the Federal Employee Identification Number is not listed.
- The complete name and original number of the California Corporation are not listed.
- Copies of the Articles of Incorporation are not submitted with the application indicating the status of the entity as a California professional corporation. The Medical Board needs to insure the corporation is active and is a professional medical corporation.
- The applicant fails to list all shareholders and (in cases where there are non-physician shareholders) the percentage of shares owned by each shareholder.
- The $70.00 application fee made payable to the Medical Board of California is not submitted with the application.
Statutory information is provided with the application. Please refer to this information and follow the instructions on the application. If you have any additional questions, please call (916) 263-2382.
Fictitious Name Permit Renewal
In California, Fictitious Name Permits must be renewed every two years. It’s a violation of the Medical Practice Act to practice under a fictitious name with an expired permit. The permit expires at midnight on the expiration date.
When renewing by mail, the renewal must be on the Board’s renewal form, and must include the current renewal fee and any delinquent fees. Please allow 6-8 weeks for processing. If a renewal notice is not received, the permit must still be renewed before the expiration date on the permit.
Forms, information about current renewal fees, and requirements may be obtained by contacting:
Medical Board of California 2005 Evergreen Street, Suite 1200 Sacramento, CA 95815 (916) 263-2382 or (800) 633-2322
General Information
Disciplinary Action Disclosure:
When renewing, each licensee must disclose whether they have had any license disciplined by a government agency or other disciplinary body, or, have been convicted of any crime in any state, the USA and its territories, military court or a foreign country. License includes permits, registrations, and certificates.
Conviction includes a plea of no contest and any conviction that has been set aside or deferred pursuant to sections 1000 or 1203.4 of the Penal Code, including infractions, misdemeanors, and felonies. You do not need to report a conviction for an infraction with a fine of less than $300 unless the infraction involved alcohol or controlled substances.
Discipline includes, but is not limited to, suspension, revocation, voluntary surrender, probation, or any other restriction.
For additional information, please contact the Medical Board’s Consumer Information Unit:
- Toll-Free: 1-800-633-2322
- Phone: (916) 263-2382
- Fax: (916) 263-2435
Renewal Restrictions
Failure to Renew:
Any physician and surgeon or doctor of podiatric medicine practicing under a fictitious name without a valid permit may lead to disciplinary action against the individual licensees.
There is no grace period; if a permit has not been renewed within 30 days following the expiration date, the Licensing Program will notify the permit holder by mail. The date a permit expires, the status is changed to “delinquent” if the renewal application and fees due are not received.
If a permit is renewed more than 30 days following the expiration date, the permit holder is required to pay additional fees.
After a permit has been in “delinquent” status for five years, the permit is automatically canceled. A canceled permit may not be reactivated. The permit holder must apply for a new permit and meet the current permit requirements.