Florida Department of State and Division of Library and Information Services

Reference: Ref-04947

Reference Name: Medical/Clinic Director Attestation, AHCA Form 3110-1028 (Sept 2014)
Agency: 59 Agency for Health Care Administration
59A Health Facility and Agency Licensing

Original Document(s):
1/7/2015 Medical/Clinic Director Attestation of Legal Responsibility for a clinic's activities.
Modified Document(s): No Modified document(s).
Description: Medical/Clinic Director Attestation of Legal Responsibility for a clinic's activities.

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted		 Section Description ID Publish
Date
View Text Final
59A-33.002 		Licensure, Application Process, General Requirements 15589954 Effective:
02/12/2015



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