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Get CT P-142OP 2017-2024

Vices Division, 60 State Street, Wethersfield, CT 06161-2510 The patient named below has been referred to the DMV Driver Services Division concerning their ability to safely operate a motor vehicle. This medical report must reflect the results of the medical professional's (licensed physician, eye care professional, PA or APRN) personal examination of the patient performed within Address incident of 90 days of this report being filed. It must be signed by the patient authorizing the medical pro.

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