Document
Attachment D Practitioner Reporting Form
ICR 202105-0930-001 · OMB 0930-0234 · Object 111920301.
This document may belong to an older filing. More recent activity for OMB 0930-0234:
Document Viewer [doc]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 140 · attempts 1 · next 2026-08-01 02:11:48)
Missing: html
Download: Source copy (doc)
Loading document viewer…
Document Metadata
| File Type | application/msword |
|---|---|
| File Title | Attachment D Practitioner Reporting Form |
| Author | Windows User |
| Last Modified By | SYSTEM |
| File Modified | 2019-11-26 |
| File Created | 2019-11-26 |
| Conversion State | partial |