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Fias fu f filled tfte requiranents of C~iap~er 458, Florida Statutes, 9 irt9 tFte praetiee of
medicine and is fieneb}? a~ed to practice
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' ,t : s : ~ ~ in ~e State of Florida.
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. • r ; ~n ~itttssta ~l~ercof, we 6pur (~errunto subscribed our names and affixed tfre Seal of tie Board of
JVtedical •~raminers ~iis day ~.~D., i9
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- ~ • CGairmun
i s , , ~ ' Samar a~•Flo,idn
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To the Ckric of the Circuit Coup of ~ L County. l ' of
NAME OF COUNi'Y l,N
~$b /t~tf(/(fisW~~ /yfCr born at f~c'A . , on the '~L-!' /d'~ 19,E
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day of ~iy~ , /~J / ,graduated at ~P date %)7r~, /1'12
who. being duly sworn, uys. l am the person rramod in the foregoing Certificate. and am the lawful possessor of same. I have, before
receiving this Certificate. complied with all statutory requirements governing the practice of modicine; that no money has been paid for
such Certificate, eaoept the regular fee paid by all applicants. and that no fraud. mistepnesentation. a mistake in any material regard was
empbyed by anyone, or oceurred in order that such Certificate should be granted.
- Signed
County of S T. t_ U C I E
State of F L O R I D A
Sigrrcd and sworn to before me this 5TH day ~ NOVEMBER , l q 8 0
Signature of Officer
STATE OF F[.ORIDA I. ROGER PO I TRAS , Ckrk of the Circuit Court in acrd for said
County Of S T. L U C I E - County ~ do certify that ALFRED L G I A N F A G N A
of FORT PI ERCE~ FLOR 1 DA has this
- day negister+ed the foregoing Certificate and affidavit in my office.
~~113 WITNESS: My hand and the seal of said Circuit Court at ~T H
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F1LE0 AND RECO~tOED ~ ~Z L~1 ti,?1
ST.LUCtE ~ ~iJh i FLA, day of NOVEMBER Iq
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C! rte.. J ~ ,ter n 7~ ~d
RECCi..~ v'- ~ tE __,~d ROGER P'01 TAS
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