DH-MQA 1249, Revised 05/2020, Rule 64B15-12.010, F.A.C. Page 1 of 21

State of Florida

Department of Health Board of Osteopathic Medicine

Application for Temporary Certificate for

Practice in an Area of Critical Need

Board of Osteopathic Medicine 4052 Bald Cypress Way, Bin #C-06

Tallahassee, FL 32399-3256 (850) 488-0595

Section 459.0076, Florida Statutes

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