Rev. 7/1/09 form 2b manfred blum, m.d. f.a.c.p. nyu school of medicine 530 first avenue new york, n.y. 10016 office:phone (212) 2637 fax (212) 2630401 lab: phone (212) 2637410 fax: (212) 2637519 thyrogenradioactive iodine (i131) whole body scan...
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Rct-131 (11-11) (i) 1310001 gross receipts tax report private bankers bureau of corporation taxes po box 280407 harrisburg pa 17128-0407 2011 report corp tax account id name (department use only) date received address federal id (ein) city o state...
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De-131 attorney or party without attorney (name, state bar number, and address) : telephone and fax nos.: for court use only to keep other people from seeing what you entered on your form, please press the clear this form button at the end of the...
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.overlakehospital.org /imaging phone: (425) 6880100 fax: (425) 4548911 please bring this form with you to your appointment last name: daytime phone: insurance carrier: appointment date: first name: evening phone: cpt code: appointment time: date...
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Experiencj:j; in 'rr pjping iodine 131 and otmm fission prodljc ts f..ei,eased ,from irradiated agr type fuel .e:l:emen ts by d. a. coi,lrns r. taylor w. d. yu.l:!; sul ' 'iiary iodine131 and other fission products have been rele;sed from...
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Omb no.1615-0090; expires 02/28/2015 department of homeland security u.s. citizenship and immigration services form i-687, nwirp class member worksheet northwest immigrant rights project (nwirp) class member worksheet notice to nwirp class member...
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New register house edinburgh eh1 3yt switchboard extract ordering service fax e-mail web +44 131 334 0380 +44 131 314 4411 +44 131 314 4400 records gro-scotland.gsi.gov.uk http://.nrscotland.gov.uk application for certificate(s) searching...
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Form 131c. petition to adopt minor by a parent's partner state of vermont district of probate court docket no. in re: adoption of petition to adopt minor by parent's partner 15a v.s.a. ? 4-107 1. 2. 3. 4. my full name is: my date and place of...
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I131 referral guidelines patient name: owner name: breed: age: sex: m nm f sf referring veterinarian: phone: below are guidelines/requirements for referral for i131 therapy. if you have any questions, please let us know and we can help you and...
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Home care and radiation safety instructions owner name: patient name: your cat will be treated with radioiodine (i131). you may notice some changes in your cat in the first month after he/she returns home. these changes are related to changing...
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Princeton law group(practice restricted to immigration & natz. law)3735 lawrenceville roadprinceton, nj 08540telephone:facsimile:609-620-0949609-620-0955joseph asir, [email protected] to the bar of ny(member
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Hub and spoke network design for the inbound supply chain by olufemi oti b.s. industrial engineering university of florida, 2006 submitted to the mit sloan school of management and the engineering systems division in partial fulfillment of the...
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Imperial county planning & development services department owner, operator and agent: 1. applicant (name, mailing address and telephone number): 2. property owner (s), or owner of surface rights (name, mailing address and telephone number): if...
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No securities regulatory authority has expressed an opinion about these securities and it is an offence to claim otherwise.this short form prospectus constitutes a public offering of these securities only in those jurisdictions where they may be...
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Well logging application review check list item 8.1 type of applicant/licensee type of action license no. a. new license not applicable b. amendment u c. renewal 42-26891-01 item 8.2 name of applicant/licensee legal name: weatherford...
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