PROFESSIONAL MEDICAL QUALIFICATIONS (eg Key Specialities, Administration, Management) Name of Part No. with Final with Date Registration/Enrolment Expiry Date to be taken Professional Date & Result & Result No./PIN No Body EMPLOYMENT HISTORY PRESENT POST – Are you currently registered with the GMC in the ? Yes What is your Registration No? Expiry Date of Registration? No With which Medical Council are you registered? Expiry Date of Registration? Please note Appointment will be subject to confirmation of registration
PROFESSIONAL MEDICAL QUALIFICATIONS (eg Key Specialities, Administration, Management) Name of Professional Body Part No. with Date & Result Final with Date & Result Registration/Enrolment No./PIN No Expiry Date to be taken EMPLOYMENT HISTORY – PRESENT POST Are you currently registered with the GMC in the ? Yes What is your Registration No? Expiry Date of Registration? No With which Medical Council are you registered? Expiry Date of Registration? Please note Appointment will be subject to confirmation of registration
Combined-Information-Application-pack-TDC-MO.docx