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Get Healthcare Criminal History Background Affidavit - Mississippi State ... - Msdh Ms

Ppeared the undersigned ,who, after being by me first duly sworn did state upon his/her oath as follows: a. That the affiant is currently employed by , a licensed facility/entity by the Mississippi State Department of Health, or by another entity employed by a licensed facility/entity on a contractual basis. b. That the affiant has not been convicted of or pleaded guilty or nolo contendere to a felony of possession or sale of drugs, mu.

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