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ARIZONA MEDICAL BOARD POSTGRADUATE TRAINING VERIFICATION FORM AUTHORIZATION The Arizona Medical Board requires all applicants for licensure to obtain verification of all postgraduate training programs attended. This form must be completed by the Program Director. This is authorization to release any information in your files of record favorable or otherwise DIRECTLY to the Arizona Medical Board. Authorization may be sent via mail or fax to 9545 E Doubletree Ranch Road Scottsdale AZ 85258 or 480 551-2704. First Name Last Name Signature Date Important - Program Participation Report incomplete postgraduate years PGY separately from those that were successfully completed* If the postgraduate year is currently in progress report the expected completion date in the To field. Report internships residencies and fellowships separately. PG Year Department/Specialty Internship Residency Fellowship From To Successfully Completed mm/dd/yy Yes No In Progress Affix Training Program Seal Here This pro....

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Verification of Arizona license to practice PT and certification to work as a PTA may be ascertained on the eLicensing website. Information can also be obtained by calling our office at 602-274-0236.

Look up the physician license information on your Arizona doctor at the official website of the AZ Medical Board. Find additional information on his/her Education and Training, whether there are any AZ Board investigations, and Malpractice / Criminal information. Use Doctor Search for doctor license lookup.

Look up the physician license information on your Arizona doctor at the official website of the AZ Medical Board. Find additional information on his/her Education and Training, whether there are any AZ Board investigations, and Malpractice / Criminal information. Use Doctor Search for doctor license lookup.

Cara M. Christ, M.D., M.S. became Director for the Arizona Department of Health Services in May 2015.

AZ Medical Board - Regulation.

Check Doctor Accreditations A state or local occupational and professional licensing board will be able to give you this information. Use the American Board of Medical Specialties (ABMS) Certification Matters lookup to find out if a doctor is board-certified in the appropriate specialty.

Have met all applicable education, work, exam, and /or clinical supervision requirements in the other state where originally licensed or certified. Complete a criminal background check when required by law. Take and pass any applicable exam on Arizona state law. Pay all applicable fees to the AMB. Licensure by Universal Recognition - Arizona Medical Board azmd.gov https://azmd.gov › Home › HeaderNotice › HeaderNotice azmd.gov https://azmd.gov › Home › HeaderNotice › HeaderNotice

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232