Central Registry Clearance Request - DHS-1929 - Michigan

Michigan Department of Health and Human Services SECTION 1 INFORMATION ON PERSON BEING CLEARED ... For questions about completing this form, please contact the local Michigan Department of Health and Human Services, see attached contact list. ... MI 49684 231-941-3900 231-941-0037 Lenawee 1040 S. Winter St. Ste. 3013, Adrian, MI 49221 517-264 ... ................
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