This government document is issued by Respiratory Care Board for use in California
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https://www.google.com/url?client=internal-element-cse&cx=001779225245372747843:ds0ypfibnsy&q=https://www.rcb.ca.gov/licensees/forms/request_for_active_status.pdf&sa=U&ved=2ahUKEwj37IyNir_xAhXGxIsKHQFCBZI4PBAWMAZ6BAgGEAE&usg=AOvVaw0-YVGinBB2UD3pMdG6xmQX