Ref-01747 DR-416  

 
DR 416 R 11-12 physician certificate.doc
Form Title: Physician's Certification of Total and Permanent Disability   10/5/2012
DR-416.pdf
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

Description:

Form Title: Physician's Certification of Total and Permanent Disability