Section Pari 806.09 - Supplemental Application Form for Greyhound Veterinarian or Veterinarian AssistantOn a form provided by the commission, an applicant for an occupational license as a greyhound veterinarian or veterinarian assistant shall, in addition to the application form specified in Pari 806.05, supply the following information:
(a) The name of the applicant as it appears on the form specified in Pari 806.05;(b) Whether or not the applicant currently possesses a license to practice veterinary medicine in the state of New Hampshire;(c) The names of all jurisdictions in which the applicant has been admitted to the practice of veterinary medicine and the year of admission to practice;(d) Whether or not the applicant's license to practice veterinary medicine in this or any other jurisdiction is subject to suspension or revocation;(e) In the case of a veterinarian assistant, the name, address and telephone number of an occupationally licensed veterinarian who has agreed to supervise the applicant;(f) The applicant's signature on the statement set forth in Pari 806.28 below; and(g) The date of the signature described in (f) above.N.H. Admin. Code § Pari 806.09