(A) The holder of a certificate to practice, issued pursuant to section 4765.30 of the Revised Code and this chapter, shall provide written notice to the division no later than thirty days following any changes in the certificate holder's:
(1) Full legal name;
(2) Home mailing address;
(3) Home telephone number ;
(4) Valid email address.
(B) A certificate holder notifying the division of a name change must submit legal documentation verifying such name change.