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CERTIFICATION OF APPOINTMENT TO AN ACADEMIC ...

CERTIFICATION OF APPOINTMENT TO AN ACADEMIC ... 2025

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The document is a certification form for the appointment of an applicant to a Michigan training hospital, required by the Bureau of Professional Licensing. It includes sections for initial licensure or renewal, applicant information, and certification by the Director of Medical Education. The form must be signed and submitted directly to the licensing office, ensuring compliance with accreditation standards for various medical programs.

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