Notification of
Disciplinary Action and/or Open Formal Complaint
Against a License or Certificate
Applicable to Nursing Licenses, Pharmacist Licenses and
Pharmacy Technician Certificates
To:
Click here to enter text.,
Supervisor and/or Manager and
Click here to enter text.,
HR Representative
Re: Open Formal Complaint or Disciplinary Action
Date: Click here to enter text.
(Today’s Date)
On Click here to enter text., the credential of Click here to enter text.
(Date of verification)
(Employee’s Name)
was listed on the State of Michigan’s Verification Web Site as having an
Open Formal Complaint or Disciplinary Action against it. The
complaint/action can be viewed at Click here to enter text. .
(link to State’s verification site)
Sincerely,
Click here to enter text.
(Employee Verifying License/Certificate)