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Get MI MMP 3501 2018-2024

Tions • • • • • • • • • This application is for a person who is 18 years of age or older and a resident of Michigan. Type or print legibly when completing the application. The original signed Application Form and Physician Certification Form must be submitted to the MMMP. Keep a copy of all documents submitted for your records. All documents must be signed within one year from the date they are received. A renewal application will only be accepted within 60 days prior to the c.

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