Which of the following is NOT a requirement for renewing a license older than three years?

Renewing an optometry license in California requires adherence to specific regulations to ensure that practitioners remain competent and informed about current practices. One of the measures includes the completion of continuing education (CE) courses, as staying updated with medical knowledge and skills is vital for effective patient care.

The requirement that is not necessary for renewing a license older than three years is completing a 20-hour continuing education course. While ongoing education is certainly encouraged and contributes to the professional development of an optometrist, it is not mandatory for the renewal of an older license. The state recognizes that other factors may be deemed more critical for maintaining a license, such as the practitioner's active practice status or their history regarding conditions that may lead to suspension.

In summary, while continuing education is important in many contexts and supports the overall quality of care provided, it is not a formal stipulation listed under the specific requirements for license renewal after three years. This makes it the correct answer in this context.