California
Statewide
Medical Board
Last updated: 2/19/2019
Fictitious Name Permit Change Of Address Form {FNP-005}
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Description
FNP-005, FICTITIOUS NAME PERMIT CHANGE OF ADDRESS FORM, Pursuant to Business and Professions Code Section 2021(a)(b), your address of record is public information and will be posted on the Medical Board’s Web site. www.FormsWorkflow.com
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