LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
OATH OR AFFIRMATION OF APPLICANT. I HEREBY swear or affirm that all statements made and information provided in or with this application are true, correct and complete; that I am the person named in the credentials herewith presented and that I am the original and lawful possessor of such documents; that the photograph submitted to LSBME is a true likeness of … ................
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