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Authorized Continuing Education Provider Renewal Application Provider Information Provider Name: Type of Provider: Individual GroupCoordinators Legal Name: Coordinators Credential #: Email Address:
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Coordinators legal name refers to the full legal name of the coordinator.
The person or entity acting as the coordinator is required to file the legal name.
To fill out coordinators legal name, provide the full legal name of the coordinator as it appears on official documents.
The purpose of coordinators legal name is to accurately identify the individual or entity acting as the coordinator.
The information to be reported on coordinators legal name includes the full legal name of the coordinator.
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