A. A physician assistant licensed in this state, prior to initiating practice, shall submit, on forms approved by the board, notification of such intent to practice. Such notification shall include: (1) The name, business address, and telephone number of the supervising physician. (2) The name, business address, and telephone number of the physician assistant. B. A physician assistant shall notify the board of any changes in or additions to his supervising physicians within thirty days of the date of such change or addition.
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