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I # t* Each section, in increments, provides greater detail from a legal standpoint and describes what resources and options are available to the nurse practitioner upon graduation and beyond. Pursuant to the Business and Professions Code section 3502.3, a practice agreement shall include the following provisions: The agreement must be completed before the PA starts practicing. Click the Get form key to open the document and move to editing. If you still haven't found your answer, 17 0 obj The practice of dentistry or dental hygiene or the work of a dental auxiliary. of the California Code of Regulations as those provisions read on June 7, 2019, shall complete, as part of their continuing education requirements, a course that . (emphasis added). Additional requirements related to this topic are discussed in BPC section 3502.1. In September 2020, Governor Gavin Newsom signed Assembly Bill (AB) 890 (Wood, Chapter 265, Statutes of 2020) into law which created two new categories of Nurse Practitioners (NPs) that can function within a defined scope of practice without standardized procedures.. Under direction, to plan, provide, and evaluate generalized health care services in a community health setting or health treatment facility; to provide direct and indirect patient care services; and to do other work as required. What are the Time Limits for Reinstatement? More information on the regulations can be found here: BRN Approved Regulations. !-68k-/Fa|b%a=e_VIX;5>[nJFUXxXnSDI(X?(ZmXqU% The Nurse Practitioner is a registered nurse with additional skills in and responsibility for physical diagnosis, psycho-social assessment, and management of health-illness needs in primary care. A Physician Assistant may not perform any of the following medical services pursuant to BPC section 3502 (d): A Physician Assistant may not perform any of the following medical services pursuant to Business and Professions Code (BPC) section 3502 (d): A PA may perform a routine visual screening pursuant to BPC section 3501(h) as a noninvasive, nonpharmacological simple 217 0 obj <>/Filter/FlateDecode/ID[<89C7B48459930547A3CDDDD11E7BFD56>]/Index[199 26]/Info 198 0 R/Length 92/Prev 153515/Root 200 0 R/Size 225/Type/XRef/W[1 3 1]>>stream What are the eligibility requirements to become a 103 NP? These out-of-state personnel are authorized only to administer Covid-19 vaccines in California and are not subject to the requirements of EMSA's approval process for out-of-state providers seeking authorization to provide health services in California. The agreement does not need to be submitted to the Board. 2. 625, Unlawful Appointment Investigation Delegation, Unlawful Appointment Investigation Delegation Agreement Template, Unlawful Appointment Process for Non- Delegated Departments, Delegation Project Frequently Asked Questions, Personnel Functions ("Who Does What - SPB/DPA"), Introduction to Key Performance Indicators, Part 1 - Identify and Prioritize Key Positions, Workers' Compensation and Reasonable Accommodation for HR Professionals, CalPERS Retirement Options for CEA and Exempt Appointments, Coverage and Costs for Certain Procedures - Indemnity and Paid Provider Option (PPO), Coverage and Costs for Certain Procedures - Prepaid Plans, Retiree Group Legal Services Insurance Plan. The role of the Nurse Practitioner is to integrate health maintenance, disease prevention, physical diagnosis, and treatment of common episodic and chronic problems in primary care with equal emphasis on health teaching and management. Search 13 0 obj Has been certified as an NP by the California Board of Registered Nursing. Furthermore, the law requires a licensee to first work as a 103 NP in good standing for at least 3 years prior to becoming a 104 NP. endobj %PDF-1.5 % <> A PA that is authorized through a practice agreement to issue drug orders for Schedule II controlled substances must register with the United States Drug Enforcement Administration (DEA) obtain a DEA number, and complete a one-time course in compliance with sections 1399.610 and 1399.612 of Title 16 of the California Code of Regulations. %PDF-1.6 % %%EOF @D)&2JB!((haj) ,L}PXF\l. hbbd```b``z"I~|Kjl{0`80 <>/Subtype/Form/Type/XObject>>stream 1 More than one supervising physician may sign the delegation of services agreement only if each supervising physician has delegated the same medical services. y gZl_JQ@/ <2(%04c/rrxb:d #-gN7O:"T0rI%0,E;.+;9t" w`c'vkY.DYkFF aO> I[g`i&&, STATE OF CALIFORNIA STATE AND CONSUMER SERVICES AGENCY. HMO0>$qv4iWH.+E]`iT,. Find up to date resources on the new resources page. How does the Board verify an applicant has completed their transition to practice? CalHR accepts no responsibility for the content or accessibility of external websites or external documents linked to on this website. Execute Delegation Of Services Agreement in just a few minutes by following the instructions listed below: Choose the document template you will need in the library of legal form samples. endstream endobj startxref They can diagnose a patient, order tests, prescribe medication, and operate their own independent practices. The DCA License Search is an online search tool that is available to the public and is used to verify a professional license issued by the various Boards and Bureaus under DCA. Delegation of Services Agreements Title 16, Division 13.8, Article 4, section 1399.540 was amended to include several . H1 endstream endobj 2373 0 obj <>/Metadata 98 0 R/Pages 2370 0 R/StructTreeRoot 120 0 R/Type/Catalog>> endobj 2374 0 obj <>/MediaBox[0 0 1008 612]/Parent 2370 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 2375 0 obj <>stream 10Y1uz10[( 1 The agreement must address the types of medical services the PA is authorized to perform, Policies and procedures to ensure adequate supervision of the PA, Methods for the continuing evaluation of the competency and qualifications of the PA, The furnishing or ordering of drugs or devices by a PA. Any additional provisions agreed to by the PA and physician. A PA may perform an examination and give an evaluation of the patient. Advanced Nurse Practitioner / Physician's Assistant: Name and title Date <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 11 0 R/Rect[411.36 652.8 531.36 665.16]/StructParent 5/Subtype/Widget/T(Approved by)/TU(Approved by)/Type/Annot>> The Nurse Practitioner works in collaboration with a physician. Fellow. Possession of a valid license to practice as a professional registered nurse in the State of California. the FAQs by keyword or filter by topic. %PDF-1.4 % Annual Leave Comparison Chart. The Board is working to fix this system glitch and is anticipating it will be remedied by the first part of March. Have a different question? In accordance with established protocols and in collaboration with a physician, provides clinical assessment and case management services to individuals including constructing and interpreting a medical history, performing a physical assessment, evaluating patient behavior, performing and interpreting selected laboratory tests, identifying problems, and developing and implementing treatment plans for patients; seeks expert opinion or advice of a physician when case falls outside of protocol of agency; refers patients to physician for consultation and to specialized health resources for treatment but retains responsibility for the clinical management as well as subsequent modification. In addition, Business and Professions Code 2837.104(c) requires a 104 NP to conduct a certain level of consultation, collaboration, and referral to other healing arts providers based on the clinical condition of the patient receiving care. <> <>/Metadata 61 0 R/OpenAction 62 0 R/Outlines 63 0 R/PageLabels 183 0 R/Pages 20 0 R/StructTreeRoot 176 0 R/Type/Catalog/ViewerPreferences<>>> meets the requirements of Business and Professions Code section 3502.3. Successful completion of a program . hb```,{@( Department of Public Health website. Failure to have a current DSA constitutes a violation of the Physician Assistant Regulations and You can verify a PA's license on-line at: supportive services. Manager. Active California Registered Nurse/Physician Assistant license. endstream endobj 146 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream The PA must also have the competency to perform the medical services, and the PAs education, training, and experience must have prepared the PA to render the services, as provided in BPC section 3502(a). The Board of Registered Nursing (Board) is proud to announce that a new 103 Nurse Practitioner (NP) application is now available in BreEZe. BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY GAVIN NEWSOM, GOVERNOR . Current California Regulations can be found on the Physician Assistant Board website: . Adherence to adequate supervision as agreed to in a practice agreement that Can I open an independent practice as a 104 NP? the nursing profession as proper to be performed by a nurse practitioner. endstream endobj 200 0 obj <. State laws typically specify that healthcare providers should delegate exclusively to individuals who are properly trained and qualified to carry out the task. California (e.g., Physician Assistant National Certifying Examination or a specialty examination given by the State of California) on _____. This new authority is not automatically granted to all NPs in California on January 1st. UCSFs innovative, collaborative approach to patient care, research and education spans disciplines across the life sciences, making it a world leader in scientific discovery and its translation to improving health. They do not replace the national certification and do not expand the scope of practice beyond the role or population. endobj However, the Board is open to future discussions and potential rulemaking action(s) to address the inclusion of specialty practice areas within 16 CCR 1481(a). Medical Board of DELEGATION OF SERVICES AGREEMENT BETWEEN SUPERVISING PHYSICIAN AND PHYSICIAN ASSISTANT (Title 16, CCR, Section 1399.540) . 3 0 obj medical services rendered by the PA. Completed in direct patient care in the role of an NP in the category listed in 16 CCR Section 1481(a) in which the applicant seeks certification as a 103 NP. Please enable scripts and reload this page. This includes, but is not limited to, managing a panel of patients, working in a complex health care setting, interpersonal communication, interpersonal collaboration and team-based care, professionalism, and business management of a practice. <>stream An NP, who is board certified as a family psychiatric/mental health nurse practitioner, is licensed to provide psychiatric and limited medical care, as defined by the ANA scope of practice to adult, geriatric and pediatric populations. D kXL@@@q~ l+ Consequently, the Board cannot grant a 103 or 104 NP status in additional specialty areas. The Nurse Practitioner does not exercise supervisory responsibilities. discretion, in consultation with the nurse practitioner, nurse midwife, or PA provide written instructions to be followed by a medical assistant in the performance of tasks or endstream endobj startxref California's website. Yes, a PA may perform surgery if the supervising physician has authorized it and it is included in the PAs practice agreement. hb```f``c`a`0fc@ >&(@R b- Before authorizing a PA to perform any medical procedure, the physician is responsible for evaluating the PA education, experience, knowledge, and ability to perform a procedure safely and competently. <>/Font<>>>/Fields[7 0 R 13 0 R 15 0 R 17 0 R]>> The two new categories established under AB 890 are commonly referred to as 103 NPs and 104 NPs. endobj Any delegation of services agreement in effect prior to January 1, 2020 shall be deemed to meet the requirements of BPC Section 3502.3. Physician Assistants (PA): Every PA is required to have the following documents: 1. Therefore, the application to become a 104 NP will not be available until 2026. endobj Delegation Services Agreement (DSA) | Advanced Practice at UCSF Health Home > Licensing & Certification > Delegation Services Agreement (DSA) Delegation Services Agreement (DSA) Delegation Services Agreement (DSA) California Physician Assistant Board Resources Find up to date resources on the new resources page. hbbd```b``"A$M&He``lz_X\,.&eIFn@6y"w,2H{H~y` ,x =jBFmYSOl91V1/XwG B A Nurse Practitioner (NP) is a Registered Nurse who has additional . The 103 NP applicant is asked to enter information about the attestor and an email is then sent to the physician and surgeon requesting their attestation of the information that was entered. Faculty. After 2026, when approved by the Board to become a 104NP, a 104 NP can practice without standardized procedures outside of a group setting. The determination of the refractive states of the human eye, or the fitting or adaptation Nurse Practitioner (NP): Nurse practitioners may provide primary care and perform advanced procedures. %%EOF Graduating from a specific type of program or . hb```I,B cb 30 ux[Kjw,i ip*6l ^sib3= w45e$K7Z&%xR"B>)B~>)'T&38 Ory-JNf<9(bV `@Z\P`LLiLJ@\$+X*T@ Please turn on JavaScript and try again. 15 0 obj According to Business and Profession Code Section 2837.103, the following criteria must be met to become a 103 NP: No. ))h|2p W5O hbbd``b`j@q` How were the AB 890 regulations developed? These providers must be competent in the same specialty area or category listed in 16 CCR Section 1481(a) in which the applicant seeks as a 103 NP. &B A0_(W3L:4 The practice agreement is between the Collaborating physician and the nurse practitioner and lists the services to be performed by the nurse practitioner. No, a PA may not use the supervising physicians Drug Enforcement Administration (DEA) number. endstream endobj 147 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Currently, nurse practitioners in the state are required to enter into an agreement with a supervising medical practitioner for which they are billed between $5,000-$15,000 per year. 6 0 obj !,esLAVQK>MCV"erva|>KS_ZG[ %7 Download Ebook Delegation Of Services Agreements Physician Assistant Board contract to establishing an independently owned nurse practitioner practice. 1. A PA is authorized to perform those medical services described in the practice agreement. 7 0 obj (See BPC, 3502.3, subd. E~!5J?c54S%)|A:\pOJeTEm,g0i%Pk5+6hEzRK = 2HX@JGzB89-s!IgIaY&fx% o}8U9 OLL} O|X@j; %:m8Naxpv3|7aw'o~|"2X [;VOWaYMxW(Iv76WHJ . and Completion of the requirements for Nurse Practitioner as specified in the regulations of the Board of Registered Nurses, California Administrative Code, Title 16, Chapter 14, Article 8, Section 1482. Board and must practice under a valid written Delegation of Services Agreement, working under the direction of a licensed physician. PO BOX 944210, Sacramento, CA 942442100- . Previous bills for full practice authority, in 2013 and 2015, had failed. No. for controlled substances. Health and Safety Code section 11362.7 (a) sets forth the definition of "attending physician" for purposes of the Compassionate Use Act. 11 0 obj The NP is authorized to provide the following medical functions. endobj The extent of required supervision must be specified in the standardized procedures. endobj (a)(3).) 14 0 obj When ordering a drug, the PA is acting on behalf of, and as an agent for, the supervising physician. 224 0 obj <>stream 0 <>/Subtype/Form/Type/XObject>>stream In full practice authority states, nurse practitioners can perform the full scope of practice without a supervising or collaborating physician. Knowledges and Abilities The attestor cannot have a familiar or financial relationship with the applicant and will be attesting to the applicants completion of the transition to practice requirement under penalty of perjury. The transition to practice eligibility requirement is defined as 4600 hours or three full-time equivalent years of clinical practice experience and mentorship that are: When the new application is released to become a 103 NP, the 103 NP applicant will provide proof of completion of a transition to practice by submitting to the Board information of the provider(s) who oversaw and provided the mentorship during the transition to practice period. <>/ExtGState<>>>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> . endstream has a serious medical condition and whether the medical use of marijuana is appropriate. Recredentialing Application Packet - University of California, Davis For questions, about the 103 NP scope of practice, please contact the Boards Nursing Education Consultants at: NEC.BRN@dca.ca.gov. The Physician Assistant Practice Act authorizes a delegation of services agreement to authorize a ph ysician assistant to eng age in specified acti vities. Possession of a valid license to practice as a professional registered nurse in the State of California. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 11 0 R/Rect[422.04 666.6 528.72 678.96]/StructParent 4/Subtype/Widget/T(Approved date)/TU(Approved date)/Type/Annot>> [7 0 R 13 0 R 15 0 R 17 0 R] 2424 0 obj <>stream The Board conducted widespread outreach and engagement prior to developing the proposed regulatory language to implement AB 890. supervision: No, the supervising physician is not required to be on site when the PA is practicing; however, the supervising physician but must be available by telephone or other electronic communication at the time the PA examines a patient. standardized procedures and Delegation of Services Agreement (documents supervising agreement between supervising physician . The Board's newsletter, Medical Board of California News, is published quarterly in the winter, spring, summer, and fall. Arkansas (1995) "Practice of advanced nurse practitioner nursing" means the performance for compensation of nursing skills by a RN who, as demonstrated by national certification, has advanced knowledge and practice skills in the delivery 2. contact the Board's Consumer Information Unit for assistance. Board of California, or the Physician Assistant Board who may request it. Advance Practice Provider (APP) Certified Registered Nurse Anesthetist (CRNA) Nurse Practitioner (NP) Physician Assistant (PA) Director. 9GRvXi'fN fg`g0 p% The supervising physician is responsible for all medical services provided by the PA under their supervision and for following each patient's progress. Will the Board certify 103 NPs and 104 NPs in categories other than those outlined in 16 CCR 1481(a)? certification as a nurse practitioner who has never been qualified or certified as a nurse practitioner in California or in any other state to meet specified requirements, including Yes. endobj In September 2020, Governor Gavin Newsom signed Assembly Bill (AB) 890 (Wood, Chapter 265, Statutes of 2020) into law which created two new categories of Nurse Practitioners (NPs) that could function within a defined scope of practice without standardized procedures. A PA may perform surgical procedures requiring other forms of anesthesia if authorized by the practice agreement and only when the supervising physician is immediately available as defined by Title 16 of the California Code of Regulations section 1399.541. be performed when the supervising physician and surgeon is not on site. endstream endobj 145 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 0 199 0 obj <> endobj Nurse Practitioners, Nurse Midwives, Physician Assistants, Pharmacists, Registered Nurses, Physicians, and . 9 0 obj 28 0 obj <>/Filter/FlateDecode/ID[<08823B92CEA44340BE364B399820DD21>]/Index[14 23]/Info 13 0 R/Length 75/Prev 29031/Root 15 0 R/Size 37/Type/XRef/W[1 2 1]>>stream Certified nurse practitioners must be licensed and certified to practice as : nurse practitioners by the California Board of Registered Nursing (CCR, Title 22, Section 51170.3) . standardized procedures and Delegation of Services Agreement (documents supervising agreement between supervising physician . pab.ca.gov, endobj Scope of Practice i. To view this search tool, please visit: DCA License Search. 5 0 obj <> No, a PA cannot practice independently. However, they cannot practice beyond the scope of their clinical and professional education and training, including specific areas of concentration. An NP is trained to provide primary health care services. endobj CalHR Grievance Procedure Under the Americans with Disabilities Act, CalHR Tribal Liaison and Tribal Consultation Policy, Public Announcements - January to June 2018, Public Announcements - July to December 2018, Business Service Assistant (Specialist) Examination, Appeal of Denial of Merit Salary Adjustment, Appeal of Layoff or Demotion in Lieu of Layoff, Request for Reinstatement after Automatic Resignation (AWOL), Request for Reinstatement after Automatic Resignation of Permanent Intermittent Employee (AWOL PI), Final Decisions on Appeal of Denial of Merit Salary Adjustment, CalHR Case Number 14-S-0106: Appeal of Denial of Merit Salary Adjustment, Final Decisions on Petition to Set Aside Resignation, CalHR Case Number 14-G-0055: Petition to Set Aside Resignation, Final Decisions on Request for Reinstatement After Automatic (AWOL) Resignation, CalHR Case Number 14-B-0132: Request for Reinstatement After Automatic (AWOL) Resignation, Unit 1 - Professional, Administrative, Financial, and Staff Services, Unit 3 - Professional Educators and Librarians, Unit 7 - Protective Services and Public Safety, Unit 11 - Engineering and Scientific Technicians, Unit 16 - Physicians, Dentists, and Podiatrists, Unit 19 - Health and Social Services/Professional, Unit 21 - Educational Consultant and Library, Calendars for Alternate Work Week Schedules, Basic Group Term Life Insurance - Excluded Employees, Basic Group Term Life Insurance for Excluded Employees Enrollment, COBRA (Consolidated Omnibus Budget Reconciliation Act), Open Enrollment Frequently Asked Questions, Vacation vs. ._fZq 2 5'(IJ=oqV1:``h```Rl@,@3l/ A'-x!Q,r 1ujC0w =M1^[yMP z_kWpRi'4ub-P""LiOk[?Ch@_xp9`J* wAV|%.\54?yfQhNL^uXlz^E^E_H5;*RmIg3aL^Tj9%=WVD.H You are now leaving this website and being directed to the specific California government resource or website that you have requested. or by calling the Physician Assistant Board at (916) 561-8780. (B&P Code, Section 3502; CCR . (1) Direct and indirect patient care services that ensure the safety, comfort, personal hygiene, and protection of patients; and the performance of disease prevention and restorative measures. All NPs who wish to practice without standardized procedures, must apply to the BRN for a special certification before they can do so. 14 0 obj <> endobj `L5M$C' ?x:U WZ.6 5,0|zj *| c]sU!hA>B_-TA@17 g$ {K(s9 \% : nC These services are outlined in the Scope of Services, Paragraph III. %%EOF endstream Successful completion of a program, which conforms to the Board of endstream and Completion of the requirements for Nurse Practitioner as specified in the regulations of the Board of Registered Nurses, California Administrative Code, Title 16, Chapter 14, Article 8, Section 1482. The undersigned PA/ANP and physician(s) agree that this Delegation Protocol will govern the PA/ANP's provision of care and that it shall be reviewed at least annually and revised as appropriate. Delegation of Services Agreements - Change in Regulations Title 16, Division 13.8, Article 4, section 1399.540 was amended to include several . For additional information about the Medical Marijuana Program, please visit the Delegation of Services Agreement: Defines specific procedures identified endobj An electronic notification will be sent out to all NPs in California once the application is live, so we strongly encourage licensees to check their email routinely over the next few weeks. A new 103 NP BreEZe application is scheduled for release in January. It states that the attending physician shall complete a medical examination before providing a recommendation for medical marijuana Can a 103 NP or 104 NP work in any content area without standardized procedures? 2 0 obj California Code Of Regulations Title 16 Section 1443.5 California Code of Regulations Title 22 Section 70215. August 4, 2021 - Board Meeting AB 890 Discussion: November 18, 2020 - Board Meeting AB 890 Discussion. xSPpurb <>/Subtype/Form/Type/XObject>>stream license and there must not be any limitations on the medical license that prohibits the supervision of Physician Assistants. We ask that you submit the Add Additional Nurse Practitioner Providers application with the appropriate information in March once the system fix has been implemented. For NPs who have already submitted their application and designated an Osteopathic physician and surgeon to attest to your hours, please be aware that your application will not be able to move forward with the information that you currently have inputted as it does not correctly identify the Osteopathic physician and surgeon 20A license type and misidentifies them as a Medical physician and surgeon. 6. Review of Practice Agreement: This Practice Agreement shall be reviewed upon appointment and reappointment, and when warranted by a change in conditions or circumstances. xZ[o&E@7Eq! According to Business and Professions Code Section 2837.103(a)(1)(B) and Section 2837.104(b), a 103 or 104 NP must hold a certification from a national certifying body accredited by the National Commission for Certifying Agencies or the American Board of Nursing Specialties and recognized by the Board. H1 xSPpurb medical examination, the attending physician must record in the patient's medical record their assessment of whether the patient hWmOH++V:oRHwd!`)]IhNz'gBzAK"&iA8SCn8CIEIG. How can an employer, patient, or any interested party verify whether a licensee has been certified by the Board as a 103 NP or 104 NP? <> OPES Occupational Analysis for Nurse Practitioners (AB 890), BRNs Proposed Regulations to Implement AB 890, Regular Rulemaking Process - DCA Boards/Bureaus, Military Personnel & Spouses/Domestic Partners, National Council of State Boards of Nursing, 103 NP Works under the provisions outlined in, 104 NP Works under the provisions outlined in, A 103 NP will work under the provisions outlined in, A 104 NP will work under the provisions outlined in. The written instructions may provide that the supervisory In addition to personally completing the Physician or another qualified health care practitioner regarding any task, procedure or diagnostic # 8 DLMR_278157.1 023.132639.4 Find up to date resources on the new resources page. Medical Board of According to Business and Professions Code 2837.101, the transition to practice refers to additional clinical experience and mentorship provided to prepare a nurse practitioner to practice independently. If the PA is performing a surgical procedure that requires general anesthesia, the supervising physician must be immediately available during the procedure, as defined in section 1399.541 of Title 16 of the California Code of Regulations . No, a physician does not need approval from the Board to supervise a Physician Assistant (PA). endobj endstream endobj The law limits a physician to supervise no more than four PAs, except as provided in. Job Requisition ID: 8163 Position Summary/Position Under the direction of the department leaderhship, the Delegation Oversight Nurse, RN is responsible for oversight of clinical operations for the . Under the Advanced Practice Registered Nursing Consensus Model, licensure occurs at the level of the population foci, as core competencies are aligned with role/population foci. Please note, the law requires an NP to first work as a 103 NP in good standing for at least 3 years prior to becoming a 104 NP. endobj 16 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 11 0 R/Rect[416.76 639 530.16 651.36]/StructParent 6/Subtype/Widget/T(Effective date)/TU(Effective date)/Type/Annot>> Anticipating it will be remedied by the State of California News, is published in. And must practice under a valid license to practice as a 104 NP is working to fix system! Of marijuana is appropriate to in a practice agreement that can I open an independent practice a... 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