INA Membership Application Select Your Option(s) Iowa Neurological Association (INA) Price of Level Selected (Price Range: $0 - $100 Annually) Select Level Resident: $0 Annually Practicing Physician: $100 Annually Retired Physician: $0 Annually Enter Contact Information Prefix (i.e. Mr. Mrs. Dr.) First Name Last Name Suffix (i.e Jr. Sr. III) Designations DO FASN FACP MD PhD FACR D.O. MBA Pharm D FAAN MD MHA DCH DMRD CCD FASAM MMM FACOS FAPA PhD M.D. MEd FACS FAAD M.P.H FAAOS FAAFP MME FAAP MFA MB BCh MSc MSCE FACEP FACOG FAANS CPE M.B. B.S. CMPE FASE MS CAQ FRCR M.P.H. AGSF M.S. IBCLC MPH MD FACP JD CWSP MBChB FRCA FACC MBBS MB BCH Adm Asst. FACOOG MD FACR M.B. Ch.B. COT FACPE DFAPA CFP CPA MAcc CFA MPA PharmD FACHE M.H.A. FAANA M.D> RPH MHSR M.ED. M.D FAOCO FASMBS FACOI FPMRS FACOP E-mail The license number could not be verified. Please check your details and try again. License Number Family NameBusiness Name View Membership Terms Next Membership Options are incorrect, Please check the selected membership options Powered By GrowthZone
