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Get Kansas State Board Of Healing Arts Form

Employment must be completed and signed by director of the practice facility. I, Director of director's name at name of hospital, institution or medical care facility , address, city, county, state and zip hereby, certify that the above named applicant will be in my employ and under contract from to date date . I further certify that such physician will be under my direction and that if at any time during the . continuation of such licensure the physician shall sever their connection.

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