RIARDO
77 Birchwood Drive
Cranston, RI, 02920

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LICENSE NBR.
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I hereby make application for membership in the Rhode Island Association of Registered Dispensing Opticians and affirm that all information on this application is accurate, and that I meet the requirements for membership classifications as indicated. I pledge, if accepted, to abide by the Association's Bylaws and legally established Rules and Regulations and I further affirm that I will do everything in my power to maintain and enhance the prestige of the Optical dispensing profession.