Online l form 2002-2025

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The document is a licensure evaluation form for applicants seeking physician licensure from the Texas State Board of Medical Examiners. It requires the applicant to provide personal information and details about their affiliations with medical institutions over the past 10 years. Evaluating physicians, who must hold specific positions, are tasked with completing an evaluation based on their knowledge of the applicant's professional abilities, ethics, and character. The form includes sections for notarization and confidentiality notices.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the Applicant Section. Enter your current full name, any previous names, address, telephone number, and email. Ensure all information is accurate as this will be used for your evaluation.
Provide details about the evaluating hospital or institution, including its name and address. Specify the dates of your affiliation and your position at that time by selecting from the provided options.
In the Evaluating Physician Section, ensure that a qualified physician completes this part. They must provide their name, title, and answer questions regarding their relationship with you.
The evaluating physician should rate your professional abilities and confirm if they have any knowledge of past disciplinary actions. This section requires careful attention to detail.
Once completed, ensure that the evaluating physician notarizes their signature and seals the form in an envelope before signing over the flap.

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Versions	Form popularity	Fillable & printable
2014	4.8 Satisfied (155 Votes)
2007	3.9 Satisfied (52 Votes)
2002	4 Satisfied (53 Votes)

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Online l form 2002-2025

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See more online l form 2002 versions

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Got questions?

Can I download and print tax forms?

How do I get a PDF tax form?

How do I download a PDF tax return?

How do I get my tax return forms online?

How to get Louisiana state tax forms?

People also ask

Does the post office have IRS tax forms?

Can tax forms be filled out online?

How do you get a PDF of your tax return?

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Online l form 2002-2025

Here's how it works

How to use or fill out online l form 2002 with our platform

See more online l form 2002 versions

Complete this form in 5 minutes or less

Got questions?

Can I download and print tax forms?

How do I get a PDF tax form?

How do I download a PDF tax return?

How do I get my tax return forms online?

How to get Louisiana state tax forms?

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People also ask

Does the post office have IRS tax forms?

Can tax forms be filled out online?

How do you get a PDF of your tax return?

Related links

Try more PDF tools