Indiana state medical board license

    • [DOC File]COLLABORATIVE PRACTICE AGREEMENT - midwest-site

      https://info.5y1.org/indiana-state-medical-board-license_1_6f71d1.html

      This Collaborative Practice Agreement entered into 20th day of June, 2008, by and between Dr. Dannee J. Neal, physician duly licensed to practice medicine in the state of Indiana (hereinafter “Physician”), and Beth Pickens, advanced practice nurse, PNP duly licensed to practice advanced nursing as a pediatric nurse practitioner.

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    • [DOC File]State of Indiana - HMS Permedion

      https://info.5y1.org/indiana-state-medical-board-license_1_55a178.html

      The medical review professional may not have involvement with the case prior to its referral to independent review. Board certification is current. Current license with no history of sanctions and/or disciplinary actions. Actively practicing. Please disclose any known issues below:

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    • [DOC File]Board of Medicine Newsletter Aug 2007 - Virginia

      https://info.5y1.org/indiana-state-medical-board-license_1_d52060.html

      Vancouver, WA 05/11/06 Mandatory suspension of medical license based on suspension of license by the Medical Licensing Board of Indiana and suspension of license by the State of Washington, Dept. of Health, Medical Quality Assurance Commission. Harrison, Joy G., MD 0101-055032

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    • forms.in.gov

      I hereby authorize the Indiana Family and Social Services Administration to make any necessary verifications of the information provided herein, and further authorize and request each educational institution, medical/license board or organization to provide all information that may be required in connection with my application for participation ...

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    • forms.in.gov

      indiana state personnel department * The information on this form is Confidential and your Social Security number is being requested by this state agency in accordance with I.C. 5-10-8-7. Disclosure is mandatory, and this record cannot be processed without it.

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    • [DOC File]Medical Licensing Board of Indiana

      https://info.5y1.org/indiana-state-medical-board-license_1_c0f0c8.html

      TEMPORARY MEDICAL PERMIT. FELLOWSHIP. INFORMATION & INSTRUCTIONS. PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING AND SUBMITTING YOUR APPLICATION. If after reading the instructions you have questions please contact our office. CONTACT INFORMATION. Indiana Professional Licensing Agency. Medical Licensing Board. 402 W. Washington Street ...

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    • [DOC File]Medical Licensing Board of Indiana

      https://info.5y1.org/indiana-state-medical-board-license_1_5d1459.html

      TEMPORARY MEDICAL PERMIT. TEACHING. INFORMATION & INSTRUCTIONS. PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING AND SUBMITTING YOUR APPLICATION. If after reading the instructions you have questions please contact our office. CONTACT INFORMATION. Indiana Professional Licensing Agency. Medical Licensing Board. 402 W. Washington Street ...

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    • [DOC File]Are home health aides allowed to administer medication in ...

      https://info.5y1.org/indiana-state-medical-board-license_1_a5649f.html

      The Board of Pharmacy as promulgated rules related to medication assistance in community settings. I have attached those rules here. We also have nurse delegation in which an RN may delegate a nursing task, including administration of medications, to a home care or home health aide who is registered or certified in the State.

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    • [DOC File]KENTUCKIANA MEDICAL HEALTH ALLIANCE, RRG

      https://info.5y1.org/indiana-state-medical-board-license_1_256dea.html

      1. Are you licensed to practice medicine/dentistry in the State of Kentucky? 2. Are you licensed to practice medicine/dentistry in the State of Indiana? Will you be required to complete rotations in the State of Indiana? If yes, please provide the following: Indiana Medical License Number _____

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    • [DOC File]Medical Licensing Board of Indiana

      https://info.5y1.org/indiana-state-medical-board-license_1_a60514.html

      Indiana Professional Licensing Agency. Medical Licensing Board. 402 W. Washington Street, Room W072. Indianapolis, IN 46204. Email: pla3@pla.IN.gov (317) 234-2060 (317) 233-4236 (fax) PROCESSING TIME . Processing time depends on the applicant. The applicant is responsible for the submission of all documents.

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