Submitting Agency / Federal Government / NEVADA STATE BOARD OF MEDICAL EXAMINERS SPECIAL EVENT MEDICAL LICENSURE Applications / Nevada Department of Public Safety / NEVADA STATE BOARD OF MEDICAL EXAMINERS / Records Bureau / ABMS Board / Date_____________________________________________________________ Nevada Department of Public Safety CIVIL APPLICANT WAIVER NOTICE OF NONCRIMINAL JUSTICE APPLICANT’S RIGHTS As / State Board of Pharmacy / Federal Bureau of Investigation / National Crime Prevention and Privacy Compact Council / FBI CJIS Division / /
NEVADA STATE BOARD OF MEDICAL EXAMINERS SPECIAL EVENT MEDICAL LICENSURE Applications which appear to have been altered in any form will not be accepted. Applications must be typed or legibly handwritten in ink (illegible