Physician Specialist PEX-2230-PH9000

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Podiatrist - Physician Specialist

PEX-2230-RTF0142432
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  - This form is only one part of the application
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Thank you for considering a career with us!

I want to*

Quickly know if my qualifications fit this position's requirementsEnter details about my qualifications and submit this Required Questionnaire

My license to practice podiatric medicine was issued*

Inside USAOutside USAI'm not licensed yet
I am licensed in this USA state*

Street Address

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Medical license number*

I have valid board certification in podiatric medicine*

YesNo, I am NOT eligible yetNo, but I am eligible

The status of my residency in a program accredited by the Council on Podiatric Medical Education is*

CompletedNot completed or enrolledEnrolled

Your qualifications fit this position's requirements!

Based on your responses and subject to verification
Would you like to enter details and submit this part of your application?*

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Name of residency program completed or enrolled*
I will upload into my application verification authored by the program that my residency completed or will complete on this date *

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I understand that my entry in this form field will serve as my electronic signature. I certify that I am the author of all submitted responses and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.

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Podiatrist - Physician Specialist