Description: http://www.nchalb.org/images/xlogo.jpg

 

Relinquish License Request

Submit this form if you no longer want to keep your license active and are exempt from licensure.

Visual Verification Image

* Required

 

Thank you for notifying the Board. You will receive email confirmation when you click SUBMIT.

 

 

 

P.O. Box 97833, Raleigh, NC 27624-7833  -  PH: 919.834.3661  -  FAX: 919.834.3665  - Email: info@nchalb.org