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20th Annual Certification and Recertification Review for Physician Assistants August 912, 2016 Registration Form Please print legibly, thank you. Registrant Name Degree Address City Phone State Zip
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The purpose of the 20th annual certification is to ensure that entities or individuals are meeting their obligations as required by the regulations or requirements.
The information required to be reported on the 20th annual certification may vary depending on the specific regulations or requirements being addressed.
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