Ref-01747 DR-416

Form Title: Physician's Certification of Total and Permanent Disability   10/5/2012

Removed a duplication of language. Under the signature and address lines, the description for the license number was changed from "Florida Board of Florida Board of Medicine or Osteopathic Medicine license number" to "Florida Board of Medicine or Osteopathic Medicine license number". Section 196.101(5), F.S.   10/26/2017