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 toGrace Liu, APRN, FNP
CredentialState controlled substance registration (VA)
NumberVA-CSR-DEMO-4129
Issued byVirginia board of pharmacy (demo record)
Valid fromOct 31, 2024
Valid throughOct 31, 2026

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