> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Licenses and permits

> Every license a new practice typically needs, who it attaches to (the clinician, the entity, or the site), and the order to get them.

Licenses come in three layers, and the layer determines who applies and when.

## Clinician licenses (the person)

State professional license in every state where patients are located
([telehealth rule](/concepts/practice-models-telehealth)). **DEA
registration** for prescribers (federal, per state where you practice), plus a
**state controlled-substance registration** in the states that require their
own. Specialty boards aren't licenses but payers check them
([CAQH](/guides/caqh-setup)).

## Entity registrations (the company)

Formation with the Secretary of State, EIN, state tax accounts (income or
franchise, sales tax if you sell products, unemployment insurance), workers'
comp policy, and any state professional-entity registration (some medical and
dental boards register the PC itself).

## Site permits (the location)

| Permit                                      | Who needs it                                               |
| ------------------------------------------- | ---------------------------------------------------------- |
| Business license / certificate of occupancy | Everyone, from the city or county                          |
| Radiology / X-ray registration              | Any practice with imaging; state radiation control program |
| CLIA certificate (usually a waiver)         | Any in-office lab test, even strep or A1c                  |
| Medical waste hauler registration           | Anyone generating sharps or biohazard waste                |
| Pharmacy or dispensing permit               | Practices dispensing meds or products in some states       |
| Fire, elevator, signage permits             | Per buildout, via the landlord or contractor               |

## Sequence and upkeep

Clinician licenses first (they gate credentialing), entity registrations at
formation, site permits during the buildout month
([the 4-month plan](/start-here/launch-in-4-months) slots them). Then put
every expiry date on the [compliance calendar](/guides/compliance-calendar):
DEA every 3 years, CLIA every 2, X-ray and business licenses annually in most
states. A lapsed license is a billing stop, not a paperwork problem.

## Related

* [Get credentialed](/guides/get-credentialed)
* [CAQH from zero](/guides/caqh-setup)
* [The compliance calendar](/guides/compliance-calendar)
* [Malpractice and business insurance](/guides/malpractice-and-insurance)
* [Expand out of state](/guides/expand-out-of-state)