A new employer letter with a new end date, her passport, the state licence and degree, a current health-care worker certification, and the same evidence of citizenship; the renewal is examined as a fresh application.
Renewal is a new file, not a stamp
A renewal at a port of entry requires the same package as the first admission, updated. The employer letter must be recent, must again name the profession, describe physiotherapy duties, state the term of up to three years and the remuneration, and confirm employment rather than self-employment. The state licence and the degree or provincial licence establish the credential; if the licence has been renewed since the first entry, the current certificate goes in the file.
The health-care worker certification must be unexpired on the date of admission, which requires checking its validity months ahead, because reissuance takes time. A copy of the earlier letter and the I-94 record keeps the history consistent. If the employer instead files Form I-129 to extend status from inside the United States, the same letter and credentials go to USCIS with the filing fee on the current schedule, and she may continue working while the timely-filed extension is pending, within the limits the regulation sets.
Before choosing the border route, compare the proposed start date with the time needed to obtain any renewed health-care certificate and licence. A first file review should produce a dated checklist: employer letter, proof of citizenship, credential, current licence, certification, prior I-94 and a short explanation of any changed duties or employer name. The current certificate, rather than an old approval, settles whether the health-care requirement is met on admission day.
A mismatch between the letter and licence is a common reason the officer asks further questions. Hypothetical example: a dietitian has a new employer after a clinic merger, but carries a letter on the former clinic's letterhead and an expired state registration. She should obtain a current letter and registration before travelling, or ask the new employer to file Form I-129 if timing makes a port application unsuitable.