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Rev. 04/13 MEDICINE & SURGERY Form B Applicant s Printed Name Department of Health Professions Commonwealth of Virginia Board of Medicine 9960 Maryland Drive, Suite 300 Enrico, Virginia 23233-1463

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The Virginia Board of Medicine is a state agency responsible for regulating the practice of medicine in the state of Virginia.

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Medical professionals, including physicians and other healthcare providers, are required to file with the Virginia Board of Medicine.

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