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Your request must state the specific restriction requested and whom you want the restriction to apply. 500. 1617 Westcliff Drive Suite 207 Newport Beach CA. 92660 Tel 949 515-4111 Fax 949 515-0318 Other Permitted and Required Uses and Disclosures will be made only with your Consent Authorization or Opportunity to object unless required by law. Signature below is only acknowledgement that you have received this Notice of our Privacy Practices Patient Name Date Witness This Notice was published...

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Terry Dubrow M is a financial disclosure form that must be filed by certain public officials.

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Certain public officials are required to file Terry Dubrow M.

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Information such as income, assets, liabilities, and gifts received must be reported on Terry Dubrow M.