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Get Digit Illinois Licensed 2007-2024

N is VOLUNTARY. However, failure to comply may result in this form not being processed. CERTIFYING STATEMENT OF FINGERPRINT SUBMISSION FP-NUR APPLICANT: This form must be completed by out-of-state residents unable to utilize the livescan process for fingerprinting in the State of Illinois. Attach this certifying statement with the four-page Application for Licensure and/or Examination as proof of having submitted the required fingerprint cards to the proper authorities. 1. NAME LAST FIRST .

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