In order to apply for a license by endorsement, an applicant shall submit the following on forms provided by the department:
(1) A completed application including, but not limited to: name, address, date of birth, social security number, telephone number, and email address;
(2) An application fee determined by the department, which shall be non-refundable and non-returnable;
(3) Verification of current certification as a CLC or an ALC submitted directly to the department by the Academy of Lactation Policy and Practice; and
(4) Verification that the applicant is in good standing from all states where the applicant is currently certified and/or licensed as a lactation counselor submitted directly to the department by the certifying and/or licensing authority.