(a) Nombre, dirección física, postal y número telefónico del profesional inscrito;
(b) fecha de la solicitud de colegiación;
(c) fechas en que la Junta Examinadora aprobó su solicitud;
(d) número de su licencia;
(e) estudios superiores, grados académicos, especialidad y experiencia, donde aplique, y
(f) cursos tomados en educación continuada.
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