APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS ...

va form jun 2016 (r) 10-2850 . approved exception to sf 171 omb no. 2900-0205 estimated burden: 30 minutes . application for physicians, dentists, podiatrists, optometrists and chiropractors. see last page for paperwork reduction act, privacy act and information about disclosure of your social security number. ................
................