(1) A certificate, signed and dated within six months preceding the date of application, by a licensed physician, a licensed nurse practitioner or a licensed physician assistant to the Department of Transportation that the applicant is a person with a disability or a certificate, signed and dated within six months preceding the date of application, by a licensed optometrist that the applicant is a person with a disability because of loss of vision or substantial loss of visual acuity or visual field beyond correction;
(2) The state-issued licensing number of the licensed physician, certified nurse practitioner, licensed physician assistant or licensed optometrist who signed the certificate described in subsection (1) of this section; and
(3) The number of a driver license, driver permit, identification card or parking identification card issued to the applicant by the department. [1987 c.187 §8; 1989 c.243 §6; 1991 c.741 §2; 1995 c.462 §2; 1999 c.582 §16; 2001 c.827 §13; 2007 c.70 §331; 2008 c.1 §30; 2009 c.238 §1; 2019 c.358 §44; 2021 c.630 §4]