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Get CA CDPH 283 B 2019

__________ SECTION V (REQUIRED) I certify under penalty and perjury under the state and federal laws that the information contained in this application and supporting documents, is true and correct. It shall be unlawful for any person not certified under Health and Safety Code (1200 - 1797.8) to hold himself or herself out to be a certified nurse assistant. ____________________________________________________________ ________________________________________ Date Signature SECTION VI: TO BE C.

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