State Form 44614 - Application For A License To Practice Veterinary Medicine Or Registration To Practice Veterinary Technology Page 4

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CERTIFICATION OF EXPECTED GRADUATION
(Must be completed by the Dean, Secretary, or Registrar and must include the school seal)
I hereby certify that ___________________________________________________________________________________ , is currently enrolled
(name of applicant)
and expected to graduate from ___________________________________________________________________________________________
(name of school)
on ______________________________________________ .
(date of graduation)
Date (month, day, year)
Signature of Dean, or Registrar
SCHOOL SEAL
Please forward this certification to your school to be completed and returned directly to the following address:
Indiana Board of Veterinary Medical Examiners
Health Professions Bureau
402 West Washington Street, Room 041
Indianapolis, Indiana 46204
Page 4 of SF 44614

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