Official SealDepartment of Budget and Management

Supplemental Questionnaire

Last Name
First Name

Are you currently licensed or eligible for medical licensure by the Maryland Board of Physicians?

Yes No

Are you currently board certified in anatomic and forensic pathology by the American Board of Pathology?

Yes No

If no, would you be able to obtain board certification within 3 years?

Yes No

Have you successfully completed an ACGME approved forensic fellowship program?

Yes No

Powered by JobAps