
Last updated: 3/1/2017
Certificate Of State Board Registration {76}
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Description
State of Missouri Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102 John R. Ashcroft, Secretary of State Professional License No. Corporation named Certificate of State Board Registration This is to certify that each of the persons named below, as incorporators and/or shareholders of a proposed Professional are duly licensed or registered to practice the profession of in the State of Missouri with Name of Incorporator Name of Corporation Name of Profession Name of Board Registration or License Number Date Licensed or Registered Address City or Town . The above name(s) of Incorporator(s) are hereby approved by this State Board. Authorized Signature of State Board Printed Name Title Date Name and address to return filed document: Name: Address: City, State, and Zip Code: Corp. 76 (01/2017) American LegalNet, Inc. www.FormsWorkFlow.com