Checkout – IAN Medicine

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Is current action to investigate, suspend, limit, or terminate your professional license pending or being threatened? Yes No

Are you currently under investigation by Medicare Yes No

Has any professional license held by you been sanctioned by any Country or State Board of Examiners? Yes No

Are any complaints against you pending before any Country/State Examining Board? Yes No

Product	Subtotal
Faculty × 1 $50.00 / year	$50.00
Subtotal	$50.00
Total	$50.00
Recurring totals
Subtotal	$50.00 / year
Recurring total	$50.00 / year First renewal: September 26, 2027

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