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NORTH CAROLINA INDUSTRIAL COMMISSION THE FOREGOING ASSIGNMENT IS HEREBY ACKNOWLEDGED FORM 25N 5/2012 PAGE 1 OF 1 MAIL OR FAX TO NCIC - MEDICAL REHABILITATION NURSES SECTION 4341 MAIL SERVICE CENTER ORM RALEIGH NC 27699-4341 MAIN TELEPHONE 919 807-2616 FAX 919 508-8325 HELPLINE 800 688-8349 WEBSITE HTTP //WWW.IC.
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