Verify New York State Licensure (Certification)
Verify New York State Licensure (Certification), Revised 1/18. Complete this form. Enclose the $20 fee and submit this form with with any accompanying documents (such as another jurisdictions' forms) to the Office of the Professions at the address at the end of the form. Do not send cash. Make check or money order payable to the New York ................
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