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Get Breining Institute Certification Verification

RAS REGISTERED ADDICTION SPECIALIST VERIFICATION FORM Mail or fax to Breining Institute 8880 Greenback Lane Orangevale California USA 95662-4019 Facsimile 916 987-8823 SECTION 1. PARTY MAKING THE VERIFICATION REQUEST. Agency Name E-mail Address SECTION 3. BREINING INSTITUTE USE ONLY Verification date Verification by Breining Institute staff RAS VERIFICATION FORM 2005 Breining Institute 0512271635 wCertified RAS wRAS Intern wActive wInactive prev.

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