Transcription of Michigan Medical Marihuana Program …
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Michigan Medical Marihuana Program …
Michigan Medical Marihuana Program (517) Section A and include an ID for the cardholder listed in Section the applicable section(s) as follows: Name Change-Section BoInclude a copy of legal documentation that proves your name change ( , marriage/divorce decree, legalname change document), valid Michigan driver license or personal identification card with your new a Patient: Include a copy of your valid Michigan driver license, personal identification card, or signedvoter registration card. If a patient submits a voter registration, you must include additional proof ofidentity for verification purposes ( , government-issued document that includes your name and date ofbirth).oIf a Caregiver: Include a copy of your valid state-issued driver license or personal identification card. Address Change-Section CoIf a Patient: Include a copy of your valid Michigan driver license, personal identification card, or signedvoter registration card. If a patient submits a voter registration, you must include additional proof ofidentity for verification purposes ( , government-issued document that includes your name and date ofbirth).
For Official Use Only Date of Birth Telephone Number: Legal First Name . Middle Initial Legal Last Name Suffix (Jr., Sr., etc.)
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