A. Each active licensee shall promptly and in writing inform the board of the licensee’s current residence address, office address and telephone number and of each change in residence address, office address or telephone number that may later occur.

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B. The board may assess the costs incurred by the board in locating a licensee and in addition a penalty of not to exceed one hundred dollars against a licensee who fails to comply with subsection A within thirty days from the date of change. Notwithstanding any law to the contrary, monies collected pursuant to this subsection shall be deposited in the Arizona medical board fund.