Applicants for license under the provisions of § 36-4-19 shall subscribe to an oath in writing before an officer authorized by law to administer oaths, which shall be a part of such application, and the oath shall be made on statements in the application which shall state the following:

(1) That the license, certificate, or authority under which the applicant practiced medicine in the state, territory or province of Canada from which the applicant removed was at the time of such removal in full force and not canceled, suspended or revoked.

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(2) That the applicant is the identical person to whom the said certificate, license or commission and the said medical diploma was issued.

(3) Whether proceedings have ever been instituted against the applicant for a cancellation, suspension or revocation of said certificate, license or authority to practice medicine in any state, territory or province of Canada.

(4) Whether the applicant has ever applied for and been refused a certificate, license, authority or commission to practice medicine by any state, territory or province of Canada and if so the reason for said refusal.

(5) That no prosecution is pending against the applicant in any state or federal court or court in Canada for any offense which under the law of the state of South Dakota would constitute a felony or would be a crime involving moral turpitude.

The application shall also be accompanied by such other information as the board by its rules and regulations require.

In determining whether a South Dakota license should be issued to the applicant, the board shall take into consideration the nature, circumstances or results of any action for cancellation, suspension, revocation or refusal of the license.

Source: SDC Supp 1960, § 27.0307 as enacted by SL 1969, ch 105, § 2; SL 1973, ch 241, § 9.