Cosmetology - Corporate Salon Owner Original License

Business Information:

Enter license type:

Full Service: A Full Service Salon is authorized to offer all cosmetology services

Limited Service: A Limited Practice Salon is authorized to offer only esthetics or manicuring services.

Name (President):
Name (Vice President):
Corp. Name:
Corp. Address:
City, State Zip: , -
County of Corp. Address:

Note: If you change the name of your salon, the outside signage of the business must be changed to match the salon's name. If the names do not match, you are in violation of the Cosmetology Regulations.
Salon Name/Outside Signage:
Salon Address:
City, State Zip: , -
County of Salon Address:
Business Phone No.: - -

Federal ID:
Name of State in which incorporated and date of Certificate of Incorporation.
State: Date: / /

Resident Agent:

Name (Resident Agent):
City, State Zip: , -
Home Phone No.: - -
Business Phone No.: - -
E-mail Address:

Required Information:

Has the applicant or any of the corporate officers or management personnel of this corporation:
1. Ever been convicted of a felony or misdemeanor in any State or Federal court? Yes No
2. Ever had this type of license denied, suspended, or revoked by Maryland or any other State? Yes No
3. Been convicted of or received probation before judgment of any drug offense committed after January 1,1991? Yes No

Workers Compensation:

 I have Workers Compensation Coverage   Policy/Binder No.

Issued by the  

 I am not an employer required to provide employee coverage under the Workers Compensation Law.


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