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CRIMINAL BACKGROUND CLEARANCE TRANSFER
The license applicant or licensee who is seeking the transfer must verify the individuals identity and include a copy of the persons drivers license or a
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PROVIDER MANUAL Molina Healthcare of California (
Jan 1, 2021 This manual contains samples of the forms needed to fulfill your obligations under your Molina contract. If you are already using forms that
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Request For Live Scan Service - Community Care Licensing
If you have any questions about this form, please contact your local licensing regional office. LIC 9163 (12 15). PAGE 4 OF 4.
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