|
Certificate of Completion |
|
|
PARTICIPANT INFORMATION |
| NAME: |
John J.
Student |
| ADDRESS: |
100
First Avenue
New York, NY
|
| PROFESSION: |
MD |
| LICENSE ID: |
NY-9999999 |
| SSN
(last four): |
9999 |
|
|
|
COURSE INFORMATION |
| TITLE: |
Sample
Course Name
|
| COMPLETED
ON: |
10/28/2002 |
| SCORE: |
100% |
|
|
|
PROVIDER INFORMATION |
| NAME: |
Albert
Einstein, MD |
| ADDRESS: |
Sample
University Medical Center |
| PHONE: |
212-555-55555 |
| PROVIDER ID: |
NYMC-2000 |
| INSTITUTE: |
CE
Online Institute |
| E-MAIL: |
Einstein@sampleuniv.com |
|
|
|
CREDIT INFORMATION |
| CREDITS
EARNED: |
3.0 |
CE |
|
|
| CERTIFICATE ID: |
CRT-100001 |
| AUTHORIZED BY: |
Albert
Einstein, MD
Sample
University Medical Center
|
|
|
|
|
|
This certifies successful
completion of Sample Course. |