(1) The applicant for dental hygiene licensure by credentials shall meet the following requirements and submit a completed application. The application must include the following:

(a) a copy of the certificate of graduation from a dental hygiene school accredited by the American Dental Association Commission on Dental Accreditation, or its successor;

(b) an original score card from the Joint Commission on National Dental Examinations showing the applicant's score on and passage of the written dental hygiene examination administered by the Joint Commission on National Dental Examinations;

(c) evidence of successful passage of a clinical examination;

(d) evidence of current licensure in another state or territory of the United States and license verification from the licensing board(s) of the state(s) under whose jurisdiction the applicant is licensed or has been licensed;

(e) proof that the applicant has practiced dental hygiene continuously for a minimum of 500 hours during the one year immediately prior to application;

(f) a copy of the applicant's current CPR card;

(g) affidavits from three persons not related to the candidate, of the applicant's good moral character;

(h) a copy of a self-query of the National Practitioner Data Bank; and

(i) payment of all appropriate fees including a credentialing fee.

(2) The applicant may not be physically or mentally impaired by use of addictive drugs, alcohol, or any other drugs or substances, or by mental or physical illness, which in the determination of the board renders the individual unfit or incapable of practicing dental hygiene.

(3) Applicants shall successfully pass the jurisprudence examination with a final grade of at least 75 percent, prior to issuance of a license.

(4) Application material remains valid for six months from the time it is received in the office. If the jurisprudence examination has not been successfully passed within six months the application will be considered incomplete and a new application and fees must be submitted.