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Report of Name or Address Change CDPH 8391

Report of Name or Address Change CDPH 8391-2025

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The document outlines the requirements for individuals holding various radiologic permits and certificates in California to report any changes in their name or address within 30 days. It specifies the necessary documentation for name changes, including a certified court order and a government-issued ID. Additionally, it provides instructions for submitting the change request along with applicable fees for duplicate certificates.

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