The Board shall place the holder of a general license to practice dentistry or a general license to practice dental hygiene on inactive status and issue an inactive status registration certificate to the licensee, if the licensee: Submits to the Board an application for inactive status on the form required by the Board; and Pays to the Board the inactive status application fee set by the Board. A licensee on inactive status may not practice dentistry or dental hygiene in this State. The form provided by the Board for inactive status application or renewal shall require the individual to state: Name; Inactive status registration number, if any; Degree; School that awarded the degree; Year of graduation; Home address; Principal office address; Principal office telephone number; and Whether or not the individual is in regular practice outside this State. The Board shall waive the examination requirements of §§ 4-302 and 4-305 of this subtitle for: A dentist on inactive status who applies for a general license to practice dentistry, if the dentist has practiced dentistry regularly in any other state within 3 years of applying for the license; or A dental hygienist on inactive status who applies for a general license to practice dental hygiene, if the dental hygienist has practiced dental hygiene regularly in any other state within 3 years of applying for the license. The Board may not issue a license if the criminal history record information required under § 4–302.2 of this subtitle has not been received.