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(if you have one)Your Practice Name Here in the typeface of your choice Text on both pages is fully customizable! AUTUMN 2015Firework Fear! As firework night draws nearer, its worth thinking about
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ABC Medical Clinic
The practice owner or authorized representative
You can fill out your practice name on the online registration form or by submitting a paper application.
The purpose of the practice name is to identify and differentiate the medical clinic from other healthcare facilities.
The practice name, address, contact information, and ownership details must be reported.
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