Licensing Activities Report

Agency Type

Select the type of agency to include in the report.

Agency

Select the agency to include in the report. This field is required.

Provider Type

Select the provider whose licensing activities you want  to include in the report. This field is required.

From Date

Enter the beginning date of the reporting period. Use the format MM/DD/YYYY. This field is required.

To Date

Enter the ending date of the reporting period. Use the format MM/DD/YYYY.

To Inquiry Date

Select the last inquiry date to include in the report.