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Karen H Chao O.D. Inc. 121 S Del Mar Ave Suite A San Gabriel, CA 91776 6262870401Todays Date PATIENT INFORMATION Last Name First Name M.I. Birthday / / Male Female Ethnicity: Drivers LIC #: Marital
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Dr. Karen Chao OD likely refers to a specific optometrist or a form related to optometric practice. OD stands for Doctor of Optometry.
Individuals or entities engaged in optometric practices, such as optometrists or their business entities, may be required to file the Dr. Karen Chao OD form.
To fill out the Dr. Karen Chao OD form, one needs to provide accurate personal and business information, financial details regarding the practice, and any necessary certifications as specified in the form instructions.
The purpose of the Dr. Karen Chao OD form is likely to document and report information related to optometric practice for regulatory, tax, or business purposes.
The information required on the Dr. Karen Chao OD form typically includes practitioner identification details, financial data, practice location, and compliance with regulatory requirements.
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