Official SealDepartment of Budget and Management


#20-004608-0008
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.
1.

Do you possess a degree in medicine from an accredited college or university?
Yes No
2.
Do you have a current license to practice medicine in the State of Maryland?  Please submit a copy of your license with your application.
Yes No
3.

If yes, please provide your license type, license number and expiration date below.
4.

Do you possess a Master's degree in Public Health from an accredited college or university?
Yes No
5.

Describe your experience as a licensed physician working in the field of public health.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

Powered by JobAps