23 Request for Dispute Resolution_0915-0126

National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: 45 CFR Part 60 Regulations and Forms

Request for Dispute Resolution_0915-0126

OMB: 0915-0126

Document [pdf]
Download: pdf | pdf
State Changes
Label
OMB Number:
0915-0126
Expiration
Date:
mm/dd/yyyy

PDF Name

Item Type

Request for
Modal
Dispute Resolution

Trigger
When the user selects the link the modal is displayed
with the public burden statement content.


File Typeapplication/pdf
File TitleRequest for Dispute Resolution
SubjectNPDB forms
AuthorHealth Resources and Services Administration
File Modified2020-11-19
File Created2020-07-31

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