Transcription of Practitioner Renewal Form - Kansas.gov
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Example: bachelor of science
Practitioner Renewal Form - Kansas.gov
To complete the Renewal by mail, you will need to do the following: the Renewal the felony question. Note: If you have not been convicted of a felony, check NO and date the the completed application and non-refundable Renewal fee according to the fee schedule below$50 renewals postmarked or submitted online before midnight on the expiration date$75 renewals postmarked or submitted online after the expiration date$125 renewals postmarked or submitted more than six months after expiration of the licenselicense NAME Please renew by submitting this form along with legal documentation of name change (marriage license, divorce decree, Gov. issued photo ID, etc.) ADDRESS Please renew by submitting this form along with a legible copy of a valid, government-issue photo ID reflecting your current address.
1. If a blood spill occurs while providing a consumer service the licensee or apprentice must disinfect all non-electrical equipment, tools and implements
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