The URL can be used to link to this page

Home My WebLink About1782 . .,..._......,..~....,,,,~~...M»,. . k .w..,.,~.,w.._.._»..M_.. _ a . . 'r~:, ~ q~ ~ff~C ~ ' 725 ~~E~56 1 ~sGAnP~~A~ Counc I K°~'~~' C~ l-~<<.~v^ir~ To the Clerk of the Circuit Court of y~ NAI~ ~ NAME OP COUNTY h /r/ ~'~2 ~l AM / . ~f~• p~ ~ ~ Of.Y`~ ~ f~~ uLV 7 1'N~-~. bOCl1 a~ i~.~- d ~'I ADDIE9S , ~ ~ d1 Of 17/a y ~7 ~f ~ e gC~u1tld 1L vNl ? b(' !'c.,~,vaSvCNG'Nf' - di:~ .~V~It ~y~.7 ~ ~ y ~IQ7'AL (~LLEGE 4i ~ ; pho, being duly aworn, r+y~ I un the penon nuned ia the fongoiag license uid thr peran nu~a~d 'w the diplaw n, a Ahich I diap~yed bcfae the Florida Staa Boud of Denti:cry, and un the l~~?ful po~or of atae. I l~ve, before ; q t0 tI1! E~111ri~h0A tl~IWl~ ~ I~p: ~ f10 L1100~~ ~YY ~ trcxiving this licxnse, eomplied ~?ith ~ll tht requiranea ; bxn p~id for roch lic,we, acupt the n8ulu fa paid by ~ll applicanta, u~d c}?ac no fr~ud, miutipcaa?ation+ a ; . ~ mistskc ia any materi~l regud W~s employed by ~ny otu, or occurred in order that auch lian~e ~6ould be acu+eed. ; ~ ~ , , ,.~t- ~ ~ , S~~ ~ ; Covxrr oF ~ ~ , STATE OP ~ ~ 7 ~ ~ 19 Signed aad s~?orn to before me this ~ d~y of , ~',~~~~~e~1.aJ ` ; $ignscuce of Offiar 1~~~~ ~ , ~ . T . ; ' , ~ ~ . I ~ ~ ' ' ~ i ~ ~ ZQY ~ ~ ~ ~ ' ~ ~ v;' _y7 w ~ r , ~ „~,~~s,~ ~ Aps ~ ~ ~ ~4~Yp~~r~ ~ ~Q~ ~ r~ ~ I . . , f ~ Iw / r~ ~ g o , , =~WO ,u , , .it~~ ~ ~ .~u , ~ ~ . ~ . ~ ~ K~~ ~ -i=- t0 h t~ N ~ W~ ht~ N~ Z . ~ , , ~ . ~ ~ns ~ . • ~ ' ~ W~< f~. <~M ,~}~"""'4~1lId~A0~l0:1~W~; ~ ~ ~ ;':s~~x~ =~LN N ~~W JN~I iyn0~l~nb~i9~a319 ~ - N,, ~ ° ~ ~ , w, , ~ =W ,W sral~o~ yasa~ ~ ~ , • • ; a ~ ~ ~~~noa 3~~ni•ts , . ~ ' ~ ~~Mao~a aMr a~~ M : ; , , , ~ ~ ~ ..._..~...~~.,..~.ry . , ~s:~,~