CE Summary Form For 2020-2022 License Renewal

SUMMARY OF CONTINUING EDUCATION INFORMATION

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I,*
,O.D., License Number*
hereby submit copies of documents reflecting attendance at, or completion of continuing education courses taken between March 1, 2019, and February 29, 2020, which fulfill the continuing education requirements for renewal for the 2020-2022 license year, pursuant to NRS 636.260.
I have completed this many hours of approved Optometric Pharmaceutical Agent (formerly TPA) continuing education
I have completed this many hours of general optometric continuing education, including practice management
I have a DEA number and CS number, and have completed this many hours of substance/opioid abuse related continuing education
Upload ARBO Summary and/or CE attendance certificates
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*
- By submitting this information and checking this box, I affirm that each document is complete and correct and that all information contained in this submission is true under the pains and penalties of perjury and the requirements of NRS Chapter 636 and NAC Chapter 636 and Nevada law generally. I also acknowledge that if I have directed or authorized a person to complete or submit this information on my behalf, I, the optometrist licensed by the Nevada Board of Optometry, am fully responsible for the content of the submission.
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CE Summary Form For 2020-2022 License Renewal

SUMMARY OF CONTINUING EDUCATION INFORMATION

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