eLicense Online

Fields marked with an asterisk * are required.

Step 2. Answer Security Questions

Items with * are required.

*First Name:	First Name: is required.
*Last Name:	Last Name: is required.
*Address:	First Name: is required.
*City:	Last Name: is required.
*State:	First Name: is required.
*Zipcode:	Last Name: is required.
*SSN	SSN - Nine Digits is required.
*Birth Date	(MM/DD/YYYY) Birth Date is Invalid.