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Pep:111111(11i TRT I IR:Hill \',111\' 1Assignment and Report 2. U.I. NUMBER (ORG. SEG. CODE, ASSIGNMENT NO., P.P.C.) 76203020170321B1B 3. PERMIT/LICENSE NUMBER 4a. TARGET DATE 4b. TARGET HOURS 5/3/2017
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How to fill out wwwtmbstatetxusdla97eb8b9-720b-421e-d04eemergency visiting practitioner temporary
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Medical practitioners who wish to provide temporary emergency services in Texas as visiting practitioners require the 'Emergency Visiting Practitioner Temporary' form.
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