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Licensed Professional, please complete this page. Please return form to discuss Maine.edu or fax to 2077804403 or mail to USMC, PO Box 9300, 242 LB Hall, Portland ME 04104 Functional Limitations Form
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Start by reading through the form carefully to understand the information required.
02
Begin by providing your personal details, such as your full name, contact information, and any relevant identification numbers.
03
If applicable, indicate your professional license number and the issuing authority.
04
Fill in the section related to your professional qualifications, including your educational background, certifications, and any relevant work experience.
05
In the designated area, describe your current or most recent employment, including the name of the organization, your job title, and your key responsibilities.
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If required, provide any additional information or documentation that may support your qualifications or experience.
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Lastly, review the form to ensure that all the necessary sections have been completed accurately and legibly. Sign and date the form before submission.

Who Needs Licensed Professional Please Complete:

01
Individuals who possess a professional license, such as doctors, lawyers, engineers, or accountants, may be required to fill out the "Licensed Professional Please Complete" form.
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Organizations or institutions that employ licensed professionals may request the completion of this form to ensure proper verification and documentation of qualifications.
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Regulatory bodies or licensing authorities may require licensed professionals to fill out this form during the renewal or application process to maintain the accuracy of their records.
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A licensed professional refers to an individual who holds a license or certification in a specific profession, such as lawyers, doctors, accountants, engineers, etc.
Any individual who is working in a profession that requires licensing or certification is required to file as a licensed professional.
To fill out the licensed professional form, you need to provide information about your license or certification, the issuing authority, expiration date, and any relevant details about your professional practice.
The purpose of reporting licensed professionals is to ensure that individuals practicing in regulated professions are properly licensed and certified to maintain the integrity and standards of the profession.
The information that must be reported on a licensed professional form includes the individual's name, license or certification number, issuing authority, expiration date, and any disciplinary actions.
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