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(1) submit an application in a form prescribed by the division;
(2) pay a fee as determined by the department under Section 63J-1-504;
(3) hold a Certified Professional Midwife certificate in good standing with the North American Registry of Midwives or equivalent certification approved by the division in collaboration with the board;
(4) hold current adult and infant CPR and newborn resuscitation certifications through an organization approved by the division in collaboration with the board; and
(5) provide documentation of successful completion of an approved pharmacology course as defined by division rule.