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Fill and Sign the Medi Cal Dental Provider Handbook Denti Cal State of California Form

Fill and Sign the Medi Cal Dental Provider Handbook Denti Cal State of California Form

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Select the dentical handbook and open it.
Fill out the form and add an eSignature.
Save the dentical provider handbook, print, or email it.

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Instruction: This is a model letter. Adapt to fit your facts and circumstances. CERTIFIED MAIL RETURNED RECEIPT REQUESTED Re: Dear _____________________ : Enclosed herewith please find the Official Notice of Intent to Administratively Dissolve/Revoke which was sent to me as registered agent for the corporation. Please be advised that if you do not file the enclosed Annual Report, your corporation will be administratively dissolved within 60 days. Even though a corporation that has been administratively dissolved can be reinstated, administrative dissolution will result in the loss of limited liability protection normally afforded to shareholders of the corporation. If you desire to continue the operation of the corporation and receive the benefit of limited liability, you should file this Annual Report as soon as possible. Should you have any questions, please do not hesitate to contact me. Sincerely, BY: / Enclosure

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