Oxygen administration / Independent Government / DEPARTMENT OF HEALTH DIVISION OF EMERGENCY MEDICAL SERVICES / State Health Council / Department of Health / Emergency Medical Service / North Dakota Department of Health Division / / /
Position
additional medical director / medical director of the ambulance service / Service Day Telephone Number Evening Telephone Number Fax Number Agency E-mail Address Squad Leader / above-named physician / DIRECTOR First Name Last Name Street Address / Squad leader / PHYSICIAN MEDICAL DIRECTOR / DIRECTOR AGREEMENT / director Transport ventilator Intravenous infusion pump Unit / director of the ambulance service Equipment and supplies / medical director / North Dakota Secretary of State / Physician Medical Director for the above-named ambulance service / Director Signature Date SFN / /
[removed]NORTH DAKOTA LICENSE RENEWAL APPLICATION AIR AMBULANCE NORTH DAKOTA DEPARTMENT OF HEALTH DIVISION OF EMERGENCY MEDICAL SERVICES & TRAUMA