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- Select the appropriate renewal type based on how long your license has been expired. Indicate whether it is within 90 days or over 90 days past expiration and note the corresponding fee.
- Complete all sections regarding your employment status, primary practice setting, and specialty. Use the statistical code sheet provided to select the correct codes.
- Answer all eligibility questions truthfully. If you answer 'Yes' to any question, be prepared to provide additional documentation as required.
- Sign and date the form at the bottom before submitting it along with any required fees and supporting documents.
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