Form REG108 template
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Application for Medical Doctor (MD) Plates
Complete this form to apply for a Medical Doctor plate. Medical Doctor plates can only be registered by Massachusetts residents who are actively registered by the Board of Registration in Medicine.
The document outlines the process for Massachusetts residents, who are actively registered with the Board of Registration in Medicine, to apply for Medical Doctor plates for their motor vehicles. The requirements include completing the provided application form, having it signed by a designated representative at the Board of Registration in Medicine, and paying applicable fees. The applicant must also provide their current plate number, driver's license number, and sign an affidavit under penalty of perjury. The document includes sections for the applicant to fill out with their personal information and for the Board of Registration in Medicine to certify the applicant's medical licensure.
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