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Get FL DR-416B 2012-2024

2D-16.002 Florida Administrative Code Effective 11/12 , an optometrist licensed pursuant to Chapter 463, Mr. - Mrs. Miss Ms. Name of totally and permanently disabled person , is totally and permanently disabled as of January 1, It is my professional belief the above-named condition renders Mr. Mrs. Miss Ms. totally and permanently disabled and the foregoing Name of totally and permanently disabled person statements are true, correct, and complete to the best of my knowledge and professi.

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