A person with an inactive license to practice medicine in this State who wishes to resume active practice shall submit an application for reactivation including:
(1) a completed application form approved by the board;
(2) the applicable reactivation fee;
(3) documented evidence of compliance with applicable continued competency requirements;
(4) written verification of licensure and disciplinary history in all states in which a license has ever been issued; and
(5) a practice history, including any malpractice suits and judgments.