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REQUEST FOR LIVE SCAN SERVICE Applicant Submission A0430 ORI Type of Application Code assigned by DOJ Job Title or Type of License Certification or Permit check OIIe o Initial License I CertifiCation I Permit Renewal License I Certification I Permit Acupuncture License Agency Address Set Contributing Agency 05738 Acupuncture Board Agency authorized to receive criminal history Information Mail Code five-digit code assigned by DOJ NIA 1747 N. Marke.

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