State License Number definition

State License Number means a licensee’s professional license number assigned to that licensee by the applicable Licensing Agency.
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State License Number. P000333 Program Number: (Leave Blank Instructor Will Complete) This contract is entered into by and between King of the Road Driving School, LLC and Name of Student (as it appears on the birth certificate): Full Name First Middle Last City State Zip Phone Number Age Birth Date High School King of the Road Driving School, LLC shall provide a total of twenty-four hours of classroom instruction and six hours behind-the-wheel instruction for a fee of $ , paid in full prior to the start of the first class. Cash, check or money order will be accepted for payment. The school will provide a licensed instructor, vehicle and fuel for the driving instruction. Also, the King of the Road Driving School, LLC shall supply all written materials.
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State License Number. County License Number: Issued To:
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Examples of State License Number in a sentence

  • You may mail, fax or email the completed application to: Department of Rehabilitation Services ATTN: Network Management P.O. Box 57630 Oklahoma City, Oklahoma ▇▇▇▇▇-▇▇▇▇ Phone: ▇-▇▇▇-▇▇▇-▇▇▇▇ or ▇-▇▇▇-▇▇▇-▇▇▇▇ Fax: ▇-▇▇▇-▇▇▇-▇▇▇▇ Legal Name of Owner: Trade Name/DBA: Medicare Facility Classification: Medicare Number: State: License Number: Expiration Date: A copy of facility license is required for each state of practice.

  • You may mail, fax or email the completed application to: Department of Corrections ATTN: Network Management P.O. Box 57630 Oklahoma City, Oklahoma ▇▇▇▇▇-▇▇▇▇ Phone: ▇-▇▇▇-▇▇▇-▇▇▇▇ or ▇-▇▇▇-▇▇▇-▇▇▇▇ Fax: ▇-▇▇▇-▇▇▇-▇▇▇▇ ▇▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇.▇▇▇ Legal Name of Owner: Trade Name/DBA: Medicare Facility Classification: Medicare Number: State: License Number: Expiration Date: A copy of facility license is required for each state of practice.

  • CONTRACTOR/SUBCONTRACTOR: California State License Number: Name and Signature of Authorized Person: (Printed Name) This document is intended to provide guidelines concerning field construction inspecting and testing services for the Port of Oakland on projects under its project labor agreement.

  • Liability Company Address: Telephone ( ) - Fax ( ) - Contact: DEA License Number: Expiration Date: State License Number: Expiration Date: CLIA Number: Expiration Date: Medicaid Number: Medicare Number: Facility, , acknowledges and agrees that USA, its affiliates and/or agents, has a valid interest in obtaining and verifying information for the purpose of evaluating Facility’s credentials and qualifications.

  • For these providers, the Unique Provider Identification Number (UPIN), State License Number, Federal Tax Identification Number, Employer Identification Number, or the default value of 'PAPERCLAIM' will be the identifier.

  • CONTRACTOR/SUBCONTRACTOR: Contractor State License Number or Motor Carrier (CA) Permit Number: Name of Authorized Person (print): Signature of Authorized Person: Title of Authorized Person: Telephone Number of Authorized Person: Address of Authorized Person: State Public Works Registration Number: Purpose.

  • Liability Company Address: Telephone ( ) _____-_________ Fax ( ) _____-_________ Contact: DEA License Number: Expiration Date: State License Number: Expiration Date: CLIA Certification Number: Expiration Date: Medicaid Provider Number: Medicare Provider Number: Facility, , acknowledges and agrees that USA, its affiliates and/or agents, has a valid interest in obtaining and verifying information for the purpose of evaluating Facility’s credentials and qualifications.

  • Last Name: First Name: M.I. Business Name: State License Number: Mailing Address: City: State: Zip: Phone: Email: Last Name: First Name: M.I. Business Name: State License Number: Mailing Address: City: State: Zip: Phone: Email: 1 This application shall be subject to all additions to and changes in the laws, regulations and ordinances applicable to the proposed development until a determination of completeness has been made pursuant to LMC Chapter 21.07.

  • Social Security Number Signature of Individual or or Federal Identification Number Corporate Name By: Contractor’s State License Number Corporate Officer (if applicable) Notice of acceptance should be mailed, faxed, emailed or delivered to the following: By: (Title) BIDS DUE: April 20th, 2023 1.

  • Contractor’s State License Number is as set forth on the signature page of the Contract.