Get Or Omb Verification Of Licensure And Certification Of State Board Written Examination Grades 2015

This guide provides clear and detailed instructions on how to complete the OR OMB Verification Of Licensure And Certification Of State Board Written Examination Grades form online. Ensuring accurate completion is essential for timely processing of your application.

Follow the steps to successfully complete your form.

1. Click ‘Get Form’ button to retrieve the form and access it in your digital environment.
2. Fill out the upper portion of the form with your personal details. This includes your last name, first name, any other names you may have used, middle name, date of birth, and the last four digits of your social security number.
3. Provide your license number and the date it was issued. Include your current residential address, including street address, city, state, and zip code.
4. Indicate your authorization for the release of all relevant information to the Oregon Medical Board by signing and dating the form.
5. The lower portion of the form must be completed by the State Board. Make sure to contact them to understand the necessary fees and submission process.
6. Once the State Board completes the form, ensure they sign, affix their seal, and return it directly to the Oregon Medical Board at the provided mailing address.
7. Before submission, review all entries for accuracy. Save changes, download a copy for your records, and print the completed form if needed.

Complete your OR OMB Verification Of Licensure And Certification Of State Board Written Examination Grades online today.