Physician Assistant Application for Licensure Checklist

PROOFNew Jersey Office of the Attorney GeneralDivision of Consumer AffairsState Board of Medical ExaminersPhysician Assistant Advisory Committee140 East Front Street, 3rd Floor, Box 183 Trenton, New Jersey 08625(609) 826-7100 Assistant Application for Licensure ChecklistUse this Checklist as a guide to assure your Application is complete. Applicant s name:_____ I. Application A. Answer each question completely. B. Be sure to have the Application notarized. C. Attach one (1) passport photograph (2 x 2 ) to the Application . D. Provide a valid daytime telephone number (include area code). E. Attach additional documents (if applicable). (For example, to explain gaps in curriculum vitae history, a statement of medical activity, or other.)

check, and the check is returned by the bank due to insufficient funds, the next step in the licensure or certification process will be delayed until the fee is paid.)

Loading..

Tags:

  Applications, Licensure, Certifications, Physician, Assistant, Physician assistant application for licensure

Information

Related search queries