MARYLAND BOARD OF MORTICIANS AND FUNERAL DIRECTORS

MARYLAND BOARD OF MORTICIANS AND FUNERAL DIRECTORS

DUPLICATE LICENSE/PERMIT/REGISTRATION REQUEST FORM

To request a duplicate of a license, permit or registration, please complete this form and attach your credit card payment receipt.

Your duplicate(s) will be mailed within 7-10 business days to the address on file.

Contact Name*

Contact Email*

Contact Phone Number*

Select Duplicate: License / Permit / Registration / Inspection Sticker*

Select or enter value

Name of Licensee*

License Type*

Funeral Establishment

License / Registration / Permit Number*

Duplicate License

Fee $35/each

PAY HERE: https://mdbnc.health.maryland.gov/mort_pay/Pay_Fee_DupLicense.aspx

Fee $40/each

PAY HERE: https://mdbnc.health.maryland.gov/mort_pay/Pay_Fee_DupPermit.aspx

Fee $50/each

PAY HERE: https://mdbnc.health.maryland.gov/mort_pay/Pay_Fee_DupRegistration.aspx

Fee $40/each

PAY HERE: https://mdbnc.health.maryland.gov/mort_pay/Pay_Fee_Repl_Sticker.aspx

File Upload*

Please upload your payment receipt here.

Drag and drop files here or

Send me a copy of my responses