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Get Licensure Fee Application - Arizona Department Of Health Services
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How to fill out the Licensure Fee Application - Arizona Department Of Health Services online
This guide provides clear instructions for completing the Licensure Fee Application required by the Arizona Department of Health Services. Following these steps will help ensure that your application is filled out correctly and submitted efficiently.
Follow the steps to successfully complete your application online.
- Press the ‘Get Form’ button to access the application form and open it in your preferred document editor.
- Begin by filling in your name in the 'Name of Licensee' field. Ensure that the entered name matches the official documentation.
- For the 'Anniversary Date', enter the date your license was first issued or the date on which your renewal is due.
- If you qualify for a fee reduction through the Empower Pack Program, check the box and specify the reduced amount based on your licensed capacity.
- Review all information for accuracy. Prepare any payment required, making it payable to the Arizona Department of Health Services.
Complete your Licensure Fee Application online today to ensure timely processing!
In total, getting your license with the Arizona Medical Board will cost you $1,050+.
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