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SUMMARY SUSPENSION COVER Sheeting re: Sue McIntosh, MDI. Petition No. 2021674Sue McIntosh of Durham, Connecticut (\” respondent\”) graduated from the University of Tennessee College of Medicine

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How to fill out summary suspension cover sheet

01

Fill in your personal information such as name, address, and contact information at the top of the form.

02

Provide the details of the suspension, including the date it was issued and the reason for the suspension.

03

If required, attach any supporting documentation or evidence related to the suspension.

04

Sign and date the cover sheet to certify that the information provided is accurate.

Who needs summary suspension cover sheet?

01

Any individual who has received a summary suspension and needs to complete the necessary paperwork to address the suspension.

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What is summary suspension cover sheet?

Summary suspension cover sheet is a document filed to temporarily suspend a professional's license or certification pending investigation.

Who is required to file summary suspension cover sheet?

Professional individuals or entities who are under investigation and facing potential suspension of their license or certification.

How to fill out summary suspension cover sheet?

The cover sheet typically requires basic information about the professional, details of the investigation, and reasons for requesting suspension.

What is the purpose of summary suspension cover sheet?

The purpose is to temporarily suspend a professional's license or certification to protect the public while an investigation is ongoing.

What information must be reported on summary suspension cover sheet?

Details of the professional, investigation, reasons for suspension request, and any supporting documents.

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