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Physician Assistants Name (Please Print) THE STATE OF License Number COUNTY OF BEFORE ME, the undersigned notary public, on this day personally appeared, who, after being by me duly sworn, upon his
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Individuals who are filling out official forms or documents that require the name of a physician assistant would need this information. Examples include patient intake forms, medical record documentation, or applications for certification or licensure.
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Regulatory bodies or government agencies that oversee the practice of physician assistants may request their name as part of their records or for verification purposes.
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The physician assistant's name is a healthcare professional who is trained to practice medicine under the supervision of a licensed physician.
The healthcare facility or institution where the physician assistant works is required to file their name.
To fill out the physician assistant's name, the healthcare facility must provide their full name, license number, and any other relevant information.
The purpose of filing the physician assistant's name is to ensure transparency and accountability in the healthcare industry.
The information that must be reported includes the physician assistant's full name, license number, and any restrictions on their practice.
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