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Please print out this form and enclose printed copy with check or money order payment to:

Janet Lerman/Medical Practice CME, 336 Hazel Avenue Unit #223, Glencoe, IL 60022.

Also, submit registration form by pressing “submit” button below.

Once you submit the registration form and payment, proceed with taking the course.

NOTE: You will receive e-mail notification upon receipt of payment and upon successful completion of test. Certificates of Completion to paid participants who have completed course requirements and successfully passed the CME test will be emailed.