Please fill out the information below. If you do not have a DEA number or Maryland license number, please register here.
Note: this registration process includes an identity authentication step (questionnaire information is not stored), an electronic Memorandum of Understanding, and a required PDMP training video. It is estimated to take 30 minutes to complete the full process.

Member Title  

Prescribing DEA Number
Healthcare Professional License Number
 

License formatting:
Dentists: please enter a license number with no leading zeros (e.g. if your license number is 00321, enter 321).
Midwives: please enter a 7-character license number (e.g. 7654321).
Nurse Practitioners: please enter a 7- or 8-character license number (e.g. R654321, AC654321)
Physicians: please enter an 8-character license number (e.g. D0054321, NOT D54321)
Physician Assistants: please enter a 8-character license number (e.g. C0004321)
Podiatrists: please enter a license number with no leading zeros (e.g. if your license number is 00321, enter 321).
Veterinarians: please enter a 4- or 5-digit license number with no leading zeros (e.g. if your license number is 004321, enter 4321).
Fill these in if you are not human.
First Name:
Last Name:


Enter only the red characters to proceed.
hiiuqjvxv2f1