SECTION 1 – PROGRAM INFORMATION - New York State …
(Physician, physician assistant, RN, NP, LPN or Advanced EMT) with a license issued by NYS Department of Education (NYSED) or certification issued by NYS Department of Health (NYSDOH). (Provide details of the license/certification below. ... I have a valid New York State license to practice as a physician, physician assistant, nurse ... ................
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