VALENTINE LAURENT

The Department of Health maintains all licensing for all medical services. The Medical Board shall be resposible for the issuance of licenses which is an independent body within the Department of Health. Please review the information contained in this section before proceeding.

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Valentine Laurent
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Joined: August 10th, 2018, 5:33 pm

VALENTINE LAURENT

Post by Valentine Laurent » August 10th, 2018, 5:38 pm


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STATE OF SAN ANDREAS
LICENSE TO PRACTICE MEDICINE APPLICATION FORM


  • SECTION ONE - PERSONAL INFORMATION

  • 1. TITLE: Dr.
    2. FULL NAME: Valentine Élodie Laurent

    3. DATE OF BIRTH: 20/04/1987
    4. PLACE OF BIRTH: Quebec City, Quebec, Canada
    5. AGE AT TIME OF APPLICATION: 31

    6. PHONE NUMBER: 51542
    7. E-MAIL ADDRESS: [email protected]
    8. DOMESTIC ADDRESS: 34 Vinewood Street, Los Santos, San Andreas

  • SECTION TWO - PERSONAL HISTORY

  • 9. HAVE YOU EVER GONE BY ANOTHER NAME? IF YES, LIST ALL THAT ARE APPLICABLE BELOW:
    1. No.
    10. HAVE YOU EVER BEEN CONVICTED OF BREACHING ANY OF THE SAN ANDREAS LAW OR THAT OF ANOTHER COUNTRY?: IF YES, EXPLAIN IN THOROUGH DETAIL:
    1. No.
    11. LIST ALL AND ANY EDUCATION THAT YOU HAVE ENROLLED IN. ADD MORE FIELDS IF NEEDED:
    • NAME OF HIGH SCHOOL: Québec High School
      YEAR GRADUATED: 2004
      DEGREE(S) EARNED: Diploma

      NAME OF UNIVERSITY: Université de Montréal
      YEAR GRADUATED: 2011
      DEGREE(S) EARNED: Bachelor of Science (B.S.) in Biology

      NAME OF UNIVERSITY: Collège des médecins du Québec
      YEAR GRADUATED: 2014
      DEGREE(S) EARNED: Doctor of Medicine (M.D.)

      TYPE OF MEDICAL DOCTOR: Medical Doctor
      MCAT SCORE (COMPLEX-USA SCORE IF D.O): 512
      RESIDENCY LOCATION: All Saints General Hospital, Los Santos, San Andreas
      SPECIALIZATION: Emergency Medical Services (EMS)
      AFFILIATIONS AND OR BOARD CERTIFICATIONS: N/A
    12. LIST ALL AND ANY PREVIOUS EMPLOYMENT. ADD MORE FIELDS IF NEEDED:
    • NAME OF EMPLOYER: Canadian Armed Forces
      PLACE OF EMPLOYMENT: Deployed in Afghanistan
      OFFICIAL COMPANY TITLE: Canadian Armed Forces
      JOB DESCRIPTION: Medical Technician
      DATE EMPLOYED: 2004
      DATE DISCHARGED: 2008
      REASON OF DISCHARGE: Honorable discharge after tour of duty

      NAME OF EMPLOYER: Mlle. Marie Montmartre
      PLACE OF EMPLOYMENT: Los Santos, San Andreas
      OFFICIAL COMPANY TITLE: International Reconnaissance, Investigation, and Security
      JOB DESCRIPTION: Medical Consultant
      DATE EMPLOYED: 2014
      DATE DISCHARGED: N/A
      REASON OF DISCHARGE: N/A

      NAME OF EMPLOYER: Los Santos Fire Department
      PLACE OF EMPLOYMENT: Los Santos, San Andreas
      OFFICIAL COMPANY TITLE: Los Santos Fire Department
      JOB DESCRIPTION: Medical Doctor
      DATE EMPLOYED: August 14th, 2014
      DATE DISCHARGED: 2015
      REASON OF DISCHARGE: Resigned

  • SECTION THREE - LICENSING BASED QUESTIONS

  • 13. WHAT SORT OF PRACTICE/PROFESSION ARE YOU AIMING TO PURSUE IF LICENSED?:
    • [ ] NURSING
      [X] DOCTOR
    14. HAVE YOU EVER BEEN TRAINED IN BASIC LIFE SUPPORT AND/OR INTERMEDIATE LIFE SUPPORT?:
    • [X] YES (WHO WAS THIS PROVIDED BY?: Los Santos Fire Department)
      [ ] NO
    15. PLEASE EXPLAIN IN FURTHER DETAIL WHY YOU WISH TO ACQUIRE A LICENSE TO PRACTICE MEDICINE:
    • (( Was a medical doctor in FD so I think I would already have a license in-character. ))

      I am interested in renewing my medical license after practicing medicine as a medical doctor for the Los Santos Fire Department. I intend to be the operational medical director for a company providing ambulance services. As the required medical director, I will oversee the medical concerns of the company, verify that staff are trained, and use my knowledge of EMS procedures to ensure the company meets or exceeds medical standards in the state.

  • SECTION FOUR - DECLARATION

  • I, Valentine Laurent, hereby declare that all of the information stated within this application is true and is as accurate to my knowledge as possible. I accept that, should I be found to have lied regarding any information, I am subject to immediate disciplinary action without question. I also affirm that I understand that, should my license be accepted, I am required to learn and follow acts up to and regarding the Hippocratic Oath. This declaration also serves as a confirmation that I have filled in all aforementioned details on my own and not by another.
    DATE: 8/10/2018
    SIGNATURE: Valentine Laurent

Mikhail
Posts: 93
Joined: May 19th, 2016, 11:25 pm

Re: VALENTINE LAURENT

Post by Mikhail » August 11th, 2018, 3:51 pm


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GOVERNMENT OF SAN ANDREAS
LICENSE TO PRACTICE MEDICINE APPLICATION RESPONSE

To Ms Laurent,

We are writing to you in regards to your recent application in order to acquire a License to Practice Medicine. We would like to inform you that you remain under close review. The Department of Health has decided to accept your application into our Licensing Program. Shortly you will receive a message from one of our staff regarding the next stage which will consist of a written examination based on general medical knowledge and other information. If you have not heard from us within 24 hours then please feel free to e-mail one of our application handlers.

Best Regards.
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Doctor Gamliel Leibovitz, D.O., FACC, FACOS, FAHA, FICS, FSVS, FAOBPa.
Department of Health, Medical Licensing Board Member.
Doctor Gamliel Leibovitz, D.O., FACC, FACOS, FAHA, FICS, FSVS, FAOBPa

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