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VISUAL ACUITY RECORD P.O. Box 440367 Miami, Fl 331440367 (800) 4439353 or (305) 4439353, ext. 273 FAXED APPLICATIONS ARE NOT ACCEPTED LAST NAME : Certification # (if applicable) : FIRST NAME : MEMBER

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AWS J2 Radiographic PROV Jaeger cert ext ACUITY Ophthalmologist applicable Optometrist colorblind Certification submitting Educator cm corrective Welding Fl applicant specifications APPLICANTS renewal expiration submission FAXED Physicians documented admi

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