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Health Clinics
Duplicate License
The form may be completed online, however, it cannot be
submitted via e-mail due to the fact that all applications and forms require original
signatures. If you complete the form on-line, you must print the form and mail it to the
address below.
A duplicate or reissued license is available for a fee of $10.00. Duplicate/Reissue Form
Licensure Unit
Acute Care Facilities
PO Box 94986
Lincoln, NE 68508-9486 |

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which can be downloaded for free from Adobe Systems,
Inc.