This form must be submitted directly by the licensed veterinarian who completed the form.
Use this form ONLY if you are licensed in another state and have not attempted the CCT examination. Applicants who have passed the NBE and CCT or have passed NAVLE and whose education has been approved by New York State are not required to file Form 3 or 4.
- Section I: Complete this section of the form before sending it to the licensed veterinarian verifying your practice. More than one form may be necessary to verify the total number of years of professional practice required for endorsement.
- Section II: A duly licensed veterinarian in good standing in the state where the applicant is licensed must complete this section and return the form directly to the Office of the Professions at the address on the form.
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