SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

State controlled substance registration

Ridgeline Health Partners credential file

Issued toDr. Aisha Grant, MD
CredentialState controlled substance registration (VA)
NumberVA-CSR-DEMO-4063
Issued byVirginia board of pharmacy (demo record)
Valid fromAug 5, 2025
Valid throughAug 5, 2027

Fictional provider and number. Close this tab to return to the Credential Tracker.