4722                                      LAWS OF MARYLAND                                    Ch. 858

practice dental hygiene on inactive status and issue an
inactive status registration certificate to the licensee, if
the licensee:

(i) Does not meet the requirement of §
4-309(c) of this subtitle to have practiced actively within
3 years before the license expires;

(ii) Submits to the Board an application
for inactive status on the form required by the Board; and

(iii) Pays to the Board the inactive
status application fee set by the Board.

(2) A licensee on inactive status may not
practice dentistry or dental hygiene in this State.

[(b) An individual on inactive status     loses that

status on the April 1 after it is granted,     unless the

licensee applies for another 1-year period as   provided in
this section.

(c) Before April 1 of each year, an individual on
inactive status may extend that status for an additional
1-year period, if the individual:

(1)   Submits to the Board an inactive status
renewal application on the form that the Board provides; and

(2)  Pays to the Board the inactive status
renewal fee set by the Board.]

[(d)] (B) The form provided by the Board for inactive
status application or renewal shall require the individual
to state:

(1)  Name;

(2)   Inactive status registration number, if any;

(3)  Degree;

(4)   School that awarded the degree;

(5)  Year of graduation;

(6)  Home address;

(7)  Principal office address;

(8)  Principal office telephone number; and

(9)  Whether or not the individual is in regular
practice outside this State.