Entity or dba/trade Name Change Process 

A change in the name of the licensed provider requires that HSS be notified. The provider shall submit a new license application showing that the transaction being requested is a name change. A fee of $25 will be required to print a new license.

Please submit the following to complete this process:

  1. a “letter of intent” describing the specifics of the change that has occurred and the effective date of that change;
  2. a completed license application (HSS Form);
  3. the fee of $25, (HSS Payment Procedure); and
  4. a copy of documents or articles of incorporation from the Secretary of State’s Office indicating the change.