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Page 15 of 15 R39 Rev. 08/2012CERTIFICATION Be it known that the foregoing are (check all that apply)Regulations(check one)AdoptedEmergency RegulationsAmended as hereinabove statedRepealedby the aforesaid
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What is upcodesssuspension-or-revocation-of-licensesuspension or revocation of?
The suspension or revocation of licenses.
Who is required to file upcodesssuspension-or-revocation-of-licensesuspension or revocation of?
License holders.
How to fill out upcodesssuspension-or-revocation-of-licensesuspension or revocation of?
You can fill out the form online or by mail.
What is the purpose of upcodesssuspension-or-revocation-of-licensesuspension or revocation of?
To report any license suspensions or revocations.
What information must be reported on upcodesssuspension-or-revocation-of-licensesuspension or revocation of?
Details about the suspension or revocation, license number, date, and reason.
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