Get VA 10-2850a 1998
ATION EVER BEEN REVOKED (If "YES" explain YES NO on separate sheet) IV - THIS SECTION TO BE COMPLETED BY FACILITY DIRECTOR OR DESIGNEE CERTIFICATION: I certify that I have verified registration with State boards, and sighted visa or evidence of citizenship. Board certification has been verified (if appropriate). 19. EVIDENCE HAS BEEN SIGHTED IN REGARDS TO: CERTIFICATION AS A NURSE ANESTHETIST VISA REGISTRATION FOR ALL STATES LISTED BY APPLICANT NATURALIZED CITIZENSHIP CURRENT OR MOST RECE.
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