Audiology & Speech-Language Pathology Interstate Compact Information Page

Duplicate License or Registration Certificate

  • Fee: $10

    PayPal charges a $2 convenience fee. Your total will be $12.


    You may also mail the .pdf copy of this form with payment; or a note with your name, license/registration number, with a $10 check or money order.

    Checks/Money Orders are made payable to: NCBOESLPA
    Mailing Address:
    NCBOESLPA
    PO Box 16885
    Greensboro, NC 27416
  • Assistant Information

    Your duplicate registration certificate will be mailed to the address on file.
  • The board has my most up-to-date mailing address that has a mail receptacle. I understand that it will be mailed to the address on file.
  • Please enter an email address to receive a copy of this completed form. This is not a copy of your license or registration certificate. The license or registration certificate will be mailed to the address on file.
  • Payment Information

  • $0.00
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    Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro