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