Regulated ProfessionsOptometristsApplication Forms 419-0679 Application for Optometry License Must be accompanied by $225.00 application fee. Application Cover Letter MO 419-2428 Certificate of Licensure Social Security Number Disclosure Notice Other Forms Complication(s) Due to Contact Lenses Dispensed Without A Valid Prescription Reporting Form MO 419-2340 Application for Course Approval for Continuing Education Requirements