The board may issue an athletic trainer license to applicants who meet the requirements under this section. An applicant for licensure as an athletic trainer shall:
(1) pay a fee under section 148.7815;
(2) file a written application on a form, provided by the board, that includes:
(i) the applicant's name, Social Security number, home address and telephone number, business address and telephone number, and business setting;
(ii) evidence satisfactory to the board of current national credentialing as a certified athletic trainer by the Board of Certification for the Athletic Trainer or its recognized successor;
(iii) educational background;
(iv) credentials held in this state or in other jurisdictions;
(v) a description of any jurisdiction's refusal to credential the applicant;
(vi) a description of all professional disciplinary actions initiated against the applicant in any jurisdiction;
(vii) any history of drug or alcohol abuse, and any misdemeanor or felony conviction;
(viii) additional information as requested by the board;
(ix) the applicant's signature on a statement that the information in the application is true and correct to the best of the applicant's knowledge and belief; and
(x) the applicant's signature on a waiver authorizing the board to obtain access to the applicant's records in this state or any other state in which the applicant has completed an education program approved by the board, engaged in the practice of athletic training, or held other professional credentials;
(3) if the applicant holds or has held a credential as an athletic trainer in another jurisdiction, provide verification from the credentialing body in each jurisdiction that the applicant holds or has held a credential for the practice of athletic training; and
(4) if the applicant holds or has held a credential as another health professional in this state or another jurisdiction, provide verification from the credentialing body for that profession that the applicant holds or has held a credential for the practice of that profession.
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