Alabama Board of Medical Examiners & Medical Licensure Commission (2023)

The privilege of prescribing controlled substances in Alabama comes with the immense responsibility to protect the patient's safety as well as that of the public by preventing misuse and diversion.

Physicians, PAs, CRNPs, and CNMs who have been granted this privilege must be cognizant of and comply with all state and federal laws, rules, and regulations relating to controlled substances.

Board rules contain requirements for prescribing and dispensing controlled substancesas well as requirements specific to using controlled substances for the treatment of pain and for weight loss.

  • Prescription Guidelines
  • Guidelines for the Use of Controlled Substances
  • Dispensing Controlled Substances
  • Maintenance of Records and Inventories
  • Contact with Patients Before Prescribing
  • Prescribing Controlled Substances for Weight Loss
  • Risk and Abuse Mitigation Strategies

Prescription Guidelines

Board Rule 540-X-4-.06 states the requirements for all prescriptions for controlled substances, including:

(Video) Michael Brant Ruff M.D. - ALABAMA BOARD OF MEDICAL EXAMINERS Complaint Part 1

  • Dated as of, and signed on, the day when issued.
  • Full name and address of the patient.
  • Drug name, strength, dosage form, and quantity.
  • When oral orders are not permitted (Schedule II), written with ink or printed and manually signed (non-electronic, handwritten signature) or transmitted via an approved e-prescribing platform.
  • Employee may communicate prescription to pharmacy.
  • Two signature lines with “dispense as written” and “product selection permitted” below.
  • No person may sign in the place of or on behalf of the physician.
  • It is improper under any circumstance to pre-sign blank prescriptions and make them available to employees or support personnel.
  • It is improper to utilize blank prescriptions upon which the signature has been mechanically or photostatically reproduced.

The Board may assess administrative fines up to $10,000 for each violation or failure to comply with these guidelines.

Guidelines for the Use of Controlled Substances for the Treatment of Pain

The Board recognizes that principles of quality medical practice dictate that the people of the state of Alabama have access to appropriate and effective pain relief. The Board encourages physicians to view effective acute and chronic pain management as a part of quality medical practice, especially for patients with pain from a terminal illness.

Board Rule 540-X-4-.09states the requirements for the use of controlled substances for treating acute and chronic pain, including:

  • Evaluation of the Patient
  • Treatment Plan
  • Informed Consent and Agreement for Treatment
  • Periodic Review
  • Requirements for Medical Records

Dispensing Controlled Substances

Who Is a Dispensing Physician?

  • Orders for and delivers a controlled substance to a patient.
  • Patient consumes the medication off the premises.
  • Does not matter whether patient pays for medication or not.
  • Medications labeled as samples and are not for resale are excluded.

Who is Not a Dispensing Physician?

(Video) Michael Brant Ruff M.D. - ALABAMA BOARD OF MEDICAL EXAMINERS Complaint Part 2

  • Distributes pre-packaged samples and starter packs.
  • Administers oral or injectable controlled substances in the office.
  • Dispenses non-controlled substances.
  • Dispenses controlled substances purchased with hospital's or clinic's DEA registration.

Registration as a Dispensing Physician

  • Pursuant to Board of Medical Examiners Rule 540-X-4-.05, dispensing physicians are required to register with the Board.
  • Registration is accomplished by completing and returning the dispensing physician registration form.
  • Complete the form and return via email to the Dispensing Physician Coordinator
    • OR mail to: Attn: Dispensing Physician Registration, PO Box 946, Montgomery AL 36101-0946.
  • Every location where medications are dispensed must be registered and the separate DEA numbers listed.
  • Physicians are responsible for updating address changes, additional sites, additional DEA numbers, and removal of sites.
  • Do not submit a dispensing registration form if you do not purchase controlled substances (other than pre-packaged samples and starter packs) to be dispensed to your patients. Doing so may result in false information being provided to the Alabama Department of Public Health's Prescription Monitoring Data Bank and may result in an unnecessary investigation into your practice.

Prescription Drug Monitoring Database

  • Physicians who dispense controlled substances must report all controlled substances dispensed to the Alabama Department of Public Health Prescription Drug Monitoring Program database.
  • The Board of Medical Examiners regularly sends to the Health Department a list of licensees who have registered as dispensing physicians.

Fines for Not Registering or Reporting as Required

  • Board Rule540-X-4-.05 requires dispensing physicians to report to the prescription monitoring database and authorizesthe Board to assess administrative fines against physicians who act as dispensing physicians but are not registered with the Boardand physicians who fail to report to the database as required by the Health Department and Board rules.

Maintenance of Records and Inventories

Board Rule 540-X-4-.04 sets recordkeeping and inventory requirements for physicians who purchase,maintain, and dispense controlled substances in the office, including:

  • Inventory requirement
  • Dispensing record (sample dispensing log)
  • Labeling requirement
  • Special requirement for CII amphetamines
  • Board may assess fines up to $10,000 for each violation

Contact with Patients Before Prescribing

Board Rule 540-X-9-.11states the policy of the Board concerning performing a physical examination before prescribing medications to a patient:

(Video) Alabama Board Of Medical Examiners Dismissed Complaints I Filed Against 11 Birmingham Area Doctors!

  • When possible, prescriber should personally examine the patient.
  • Prescriber should make informed medical judgment based on appropriate history, the circumstances, and the prescriber’s training and experience.
  • Prescribing without personal exam may be suitable under certain circumstances: telemedicine, admission orders for new patient, prescribing for another physician while on call, continuing medication on a short-term basis before a new patient’s first appointment.

Prescribing Controlled Substances for Weight Loss

Board Rules, Chapter 540-X-17, provides guidelines and standards for the use of controlled substances for weight reduction.

  • Prescribing or dispensing a controlled substances for weight reduction or the treatment of obesity should be based on accepted scientific knowledge and sound clinical grounds.
  • It is illegal to prescribe a CII stimulant for the purpose of weight control, weight loss, weight reduction, or the treatment of obesity.
  • Certified Registered Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants are not authorized to prescribe or dispense any controlled substance for the purpose of weight control.
  • A prescription or order must be signed on the date the medication is dispensed or the prescription given to the patient. These prescriptions may not be called in to a pharmacy. The prescribing/ordering physician must be present at the facility at the time of the prescription.
  • Initial Requirements:
    • Initial evaluation with appropriate physical and complete history, appropriate tests and referrals.
    • BMI of 30 or above, or BME greater than 25 with at least one comorbidity; OR 25% body fat for males and 30% for females; or an abdominal girth of at least 40 inches for males or 35 inches for females.
    • Assess and document patient’s freedom from signs of drug or alcohol abuse and the presence or absence of contraindications and adverse side effects.
  • Continued use of a Controlled Substance for Weight Reduction:
    • No more than 35-day supply.
    • Within first 35 days after initiating, see the patient for monitoring the effects of therapy.
    • Continue the controlled substance only if there is continued progress towards medically established goals and patient has no significant adverse effects from medication.
    • Reevaluate patient at least once every 35 days.
    • Once goals have been met, reduce dosing and suggest drug holidays for patients in maintenance.

Risk and Abuse Mitigation Strategies

Board Rule 540-X-4-.09states the guidelines and standards for mitigating the risks of addiction, misuse, and diversion inherent in prescribing controlled substances.

These guidelines apply to the prescribing of all controlled substances for all reasons, with specific requirements with regard to opioids and benzodiazepines.


  • Provide patient with risk education.
  • As appropriate to the patient, use pill counts, drug screening,PDMP checks, abuse-deterrent medications, risk-assessment tools, and co-prescribing naloxone.
  • Morphine Milligram Equivalency (MME) and Lorazepam Milligram Equivalency (LME) standard is adopted.
  • FDA-approved daily dosage thresholds are higher for Tapentadol and other atypical opioids. The Board has not placed limits on dosage amounts but does require RMS and PDMP checks for dosages over certain MMEs.
  • Query the PDMP:
    • Less than 30 MME/3 LMC per day, review PDMP consistent with good clinical practice.
    • More than 30 MME/3 LMC per day, review PDMP at least twice a year and document use of risk and abuse mitigation strategies in the medical record.
    • More than 90 MME/5 LMC per day, review PDMP every time and on the same day the prescription is written.
  • Exemptions:
    • Nursing home patients
    • Hospice patients (prescription must indicate hospice)
    • Treatment of active, malignant pain
    • Intra-operative care
  • There is a heightened risk of adverse events associated with the concurrent use of opioids and benzodiazepines. Physicians should reconsider an existing benzodiazepine prescription or decline to add one when prescribing an opioid and consider alternative forms of treatment.

(Video) Julian Patrick Druhan M.D. - ALABAMA BOARD OF MEDICAL EXAMINERS Complaints Part 1


How do I renew my Alabama medical license? ›

Full (traditional and IMLC) (Renewal Fee $300)

Licensees must complete renewal applications personally and attest to the accuracy of the information. After renewing the license, return to the Licensee Portal to renew other licenses or registrations.

How long does it take to get an Alabama medical license? ›

The average time for obtaining a license is two to three months.

How much does a Alabama medical license cost? ›

Once you have completed the application, you will be able to pay the required fee of $150.

Who licenses doctors in Alabama? ›

Alabama Board of Medical Examiners & Medical Licensure Commission Alabama Board of Medical Examiners & Medical Licensure Commission.

How much does it cost to renew MSL license in Alabama? ›

Initial and renewal, Inactive License$50.00
Reactivation of inactive license within two years of inactive status$500.00
Reactivation of inactive license following two years of inactive status$150.00
Registration for continuing education courses provided by the Boardup to $100.00
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What happens if my medical card expires in Alabama? ›

If the medical examiner's certificate has expired, you must obtain a new one and provide it to the ALEA Driver License Division, and if applicable, if the variance has expired, you must renew it with FMCSA and provide it along with your medical certification to ALEA Driver License Division.

How hard is it to get a medical license in Alabama? ›

The Alabama Board requires only one year (12 months) of postgraduate training, assuming you attended an accredited school. If you're a U.S. applicant, verify that your residency program was: AOA-accredited (American Osteopathic Association) AMA-accredited (American Medical Association)

How much is a dispensary license in Alabama? ›

The Request for Business Application is now closed.

The Business Application Forms will issue to requestors on October 24, 2022, and applicants will have until December 30, 2022, to file their application. The non-refundable application fee for all license types is $2,500.

What states are the easiest to obtain medical licenses? ›

The Easiest States to get Medical License
  • New York. Employment, malpractice, privileges, and medical licenses are not verified in New York, making it one of the fastest states to get medical licenses. ...
  • Indiana. ...
  • Michigan. ...
  • Massachusetts. ...
  • Texas. ...
  • New Jersey.
12 Feb 2020

How much do doctors make an hour in Alabama? ›

How much does a Medical Doctor make in Alabama? As of Nov 10, 2022, the average annual pay for a Medical Doctor in Alabama is $181,807 a year. Just in case you need a simple salary calculator, that works out to be approximately $87.41 an hour. This is the equivalent of $3,496/week or $15,150/month.

How much do internal medicine doctors make in Alabama? ›

How much does a Physician - Internal Medicine make in Alabama? The average Physician - Internal Medicine salary in Alabama is $218,391 as of October 27, 2022, but the range typically falls between $196,774 and $248,184.

How much do family medicine doctors make in Alabama? ›

How much does a Physician - Family Practice make in Alabama? The average Physician - Family Practice salary in Alabama is $204,830 as of October 27, 2022, but the range typically falls between $180,414 and $235,067.

Can a NP own their own practice in Alabama? ›

Yes. The rules governing Collaborative Practice in AL do not prohibit a CRNP or CNM from owning a practice. However, CRNPs and CNMs who desire to practice are required to enter into a Collaborative Practice Agreement with a physician licensed in the state of Alabama.

Is Alabama a good state to practice medicine? ›

Alabama ranked number 11 as best place for doctors in the U.S. The state ranked 11th for opportunity and competition and 31st for medical environment. The top 10 states for doctors were: South Dakota. Nebraska.

Who regulates doctors in Alabama? ›

(5) The Board of Medical Examiners and the Medical Licensure Commission is each charged with responsibilities for protecting the public against unprofessional actions of physicians and osteopaths licensed to practice medicine in Alabama.

How long do al license last? ›

Driver's License Renewal. Your Alabama driver's license expires four years after it is issued and the expiration date is shown on the license. The license may be renewed at any time within 180 days prior to expiration.

How many hours of continuing education are required for license renewal Alabama? ›

Individuals licensed in the state of Alabama who are not exempt must satisfactorily complete courses as may be approved in accordance with regulation in the minimum number of 24 hours per biennial reporting period.

How long does it take to get Alabama compact license? ›

Examination results, available only from your Board of Nursing, will be mailed to candidates approximately 3-5 days after taking the examination. Results may also be viewed here 24-48 hours after testing.

What are the 15 conditions for medical Marijuanas in Alabama? ›

Alabama Medical Marijuana Law
  • Autism Spectrum Disorder (ASD)
  • Cancer-related cachexia, nausea or vomiting, weight loss, or chronic pain.
  • Crohn's Disease.
  • Depression.
  • Epilepsy or a condition causing seizures.
  • HIV/AIDS-related nausea or weight loss.
  • Panic disorder.
  • Parkinson's disease.
12 Nov 2022

Does Alabama recognize out of state medical Marijuanas card? ›

Alabama does not have medical marijuana reciprocity and so does not recognize out-of-state medical marijuana cards.

How far back do medical records go in Alabama? ›

§ 12‐2297: A health care provider (defined as a physician, health care institution or hospital, ambulance service, or health care services organization) must retain patient records for 6 years from the last date of treatment.

How long does an Alabama medical license last? ›

When Will Your Medical License Expire? A Complete List of State Medical License CME Requirements.
StateRenewal TermExpiration Date
AlabamaEvery yearJanuary 31
ArkansasEvery yearbirth month of current year
ArizonaEvery 2 yearsN/A
CaliforniaEvery 2 yearsLast day of clinician's birth month
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Do you have to be certified to be a medical assistant in Alabama? ›

Alabama does not require certification in order to work as a medical assistant.

Do you have to be a resident to get a medical card in Alabama? ›

Alabama Medical Card Requirements

You must be an Alabama resident. There is no age requirement, however patients under the age of 18 will need a parent or guardian to register as their caregiver.

What is the cheapest state to open a dispensary? ›

We listed Oregon and Colorado as two of the cheapest states to open a dispensary, but there are other good options, especially if initial expenses are not your biggest concern. Some states offer better market conditions, others offer lower tax rates, and some offer more flexible licensing options.

Is owning a dispensary profitable? ›

The average dispensary can generate between $100,000 and $1.2 million in annual profit. If you are the 100% owner of your dispensary, then you can expect to earn between $100k and $1.2 million in annual income as a dispensary owner.

How much is a CBD license in Alabama? ›

It will cost $2,500 for entrepreneurs to apply for medical cannabis business licenses in Alabama, and the application window opens Sept. 1. Alabama regulators also said the application fees are nonrefundable. Potential business owners can request license applications between Sept.

Can a doctor be registered in two states? ›

– As such there is no necessity of Registration in more than one State Medical Council because any Doctor, who has registered with any State Medical Council is automatically registered in the Indian Medical Register and also by virtue of Section 27 of the IMC Act, 1956, a person, whose name is included in the IMR, can ...

What states have no medical schools? ›

Delaware, Alaska, and Wyoming are the only states that lack independent medical schools.

What is the best state to practice medicine? ›

Best States to Practice Medicine
Overall RankStateTotal Score
1South Dakota69.37
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21 Mar 2022

How much does RN's in Alabama get paid monthly? ›

Registered Nurse Salary in Alabama
Hourly WageMonthly Salary
Registered Nurse RN Salary Alabama$27.83$4,824
U.S. Registered Nurse RN Salary$35.36$6,129
U.S. National Average Salary$24.34$4,218

What states have the highest paid doctors? ›

Kentucky and Tennessee have the highest average annual compensation for physicians, according to Medscape's "Physician Compensation Report 2022."

What is a good annual salary in Alabama? ›

Most salaries in Alabama range between $36,047 (25th percentile) to $64,042 (75th percentile) annually. Of course, salaries will vary depending on yor occupation, experience, and many other factors.

Who Is Highest Paid doctor? ›

What Are the Highest-Paid Doctors in the US? The highest-paid doctors in the US are neurosurgery and plastic surgery specialists, who report earning above $550,000 per year on average.

What is MD doctor salary in USA? ›

How much does a Medical Doctor in United States make? The national average salary for a Medical Doctor is $177,238 per year in United States. Filter by location to see a Medical Doctor salaries in your area. Salaries estimates are based on 480 salaries submitted anonymously to Glassdoor by a Medical Doctor employees.

What doctors make the most salary? ›

1. What are the highest paid doctors in the United States? According to the latest statistics, physicians working in the orthopedics specialty are the highest earning doctors in the US, with an average annual income of US$511K. 2.

Where do family doctors make the most money? ›

Our research found that North Dakota is the best state for family medicine physicians, while Vermont and North Dakota are ranked highest in terms of median salary.
1. North Dakota.
Total Family Medicine Physician Jobs:121
Lowest 10 Percent Earn:$147,000
Highest 10 Percent Earn:$278,000
2 more rows
6 Apr 2021

How much does a doctor make an hour? ›

As of Nov 18, 2022, the average hourly pay for a Doctor in the United States is $85.59 an hour. While ZipRecruiter is seeing hourly wages as high as $173.08 and as low as $9.13, the majority of Doctor wages currently range between $39.42 (25th percentile) to $125.00 (75th percentile) across the United States.

How much do med techs make in Alabama? ›

The average Medical Technologist (ASCP) salary in Alabama is $69,259 as of October 27, 2022, but the range typically falls between $63,949 and $75,349.

What can a doctor do that a nurse practitioner Cannot? ›

A primary difference between physicians and NPs is the fact that all doctors can prescribe medication to patients as a part of their duties. Nurse practitioners also prescribe medicine, but in some states they must be directly overseen by a doctor or physician in order to do so.

Can DNP be called doctor? ›

Yes, by earning a doctorate degree you can potentially be referred to as a “doctor.” However, some states may require DNP nurses to fully clarify their role if the title “Dr.” is used.

Is a nurse practitioner as good as a doctor? ›

A nurse practitioner will give the same quality of care as a general physician. Most nurse practitioners spend many years working as registered nurses. In their capacity as nurses, they take care of patients, performing tasks like administering medication and monitoring patients.

What is the best hospital in the state of Alabama? ›

The number 1 hospital in Alabama is University of Alabama at Birmingham Hospital.

What is the best medical school in Alabama? ›

Here are the Best Medical Schools for Research in Alabama
  • University of Alabama--Birmingham.
  • Alabama College of Osteopathic Medicine.
  • University of South Alabama.

Which state has the best surgeons? ›

Our research shows that Maine is the best state in the country for surgeons.
1. Maine.
Total Surgeon Jobs:103
Highest 10 Percent Earn:$244,000
Location Quotient:2.54 You can read more about how BLS calculates location quotients here
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6 Apr 2021

Who holds doctor's accountable? ›

The California agency charged with regulating physicians, the Medical Board of California, too often protects doctors instead of the patients it is supposed to serve.

Who keeps doctors accountable? ›

Patients trust their doctors to act responsibly and they trust state medical boards to hold their doctor accountable if they can't maintain accepted standards of competence.

Can you sue a doctor for malpractice in Alabama? ›

Whether you were harmed while seeking a diagnosis, getting treatment, or undergoing surgery, you may have a valid claim against the doctor who treated you. The sooner you start your medical malpractice claim, the more time your Birmingham medical malpractice attorney has to build your case.

How often and when do you renew your advanced practice license in Alabama? ›

An Alabama RN license is renewed every two years, concurrent with CRNP renewal. Login to My Profile section of ABN website. Complete RN and CRNP renewal. Note: There is an additional $3.50 transaction fee.

How do I renew my clinic license? ›


The licenses can now be applied online by visiting the Online Services Portal available on

How many CPD do I need to renew my license? ›


PDF) in which CPAs only need 15 CPD units to renew their PRC license. Renewing your PRC license is now easy and convenient with the PRC's latest online system for license renewal.

How many hours of continuing education must he complete each year to renew this endorsement? ›

MLOs seeking to maintain their MLO license or DRE “license endorsement” must complete 8 hours of continuing education annually.

How many hours of continuing education are required on an annual basis? ›

The continuing education (CE) requirement is 30 hours per year. The reporting period begins on January 1 following successful completion of the examination.

How long must medical records be kept in Alabama? ›

Records must be retained for at least seven years from the physician's (and/or other providers within the practice) last professional contact with the patient.

How much does a family nurse practitioner make in Alabama? ›

The average family nurse practitioner salary in Alabama is $48.87 an hour or $101,660 annually.

What are the 4 pillars of advanced practice? ›

The four pillars of advanced practice are clinical practice, leadership and management, education, and research. Advanced practitioners can be found across a range of professional backgrounds and settings including but not limited to nursing, pharmacy, paramedics, other allied health professions, and midwifery.

Where can I get my medical exam for license renewal? ›

At any LTO-accredited medical clinic or government health facility.

Do I need a medical certificate to renew my license? ›

It's part of the requirements when applying for new and renewal of driver's license.

How do I renew my clinical officer license online? ›

Apply Online Step 1: Register with the Clinical Officers Council (COC) portal. ( For new users)
  1. Select “PRACTITIONER” under the “SELECT CATEGORY” option.
  2. Input your “Registration Number”
  3. Input your ID Number.
  4. Input your email address.
  5. Then click on the “Register for Online Service” tab.
21 Oct 2022


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