Fillable Ophthalmic Dispensing Form 3 - op nysed

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Ophthalmic Dispensing Form 3 The University of the State of New York THE STATE EDUCATION DEPARTMENT Office of the Professions Division of Professional Licensing Services 89 Washington Avenue Albany, NY 12234-1000 CERTIFICATION OF OPHTHALMIC DISPENSING LICENSURE IN ANOTHER JURISDICTION APPLICANT INSTRUCTIONS 1. 2. Complete Section I in ink. Enter your name as it appears on your Licensure Application (Form 1). Be...
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