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Get FL HSMV 83039 2013

Ner under the protocol of a licensed physician or a Physician Assistant licensed under Chapter 458 or 459. LICENSED IN THE STATE OF Print/Type Name of Certifying Authority Business Address State Certifying Authority Signature Date Signed: City Zip (Area Code)Telephone Number SPECIAL EXCEPTION: The severely disabled applicant named above applying for a permanent placard is unable to obtain a Florida driver license or Identification card. If the Special Exception box is checked, the cert.

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