<p> Principal Investigator Name, academic credentials Curriculum Vitae Street Address City, State ZIP Ph: Fax: Email: Education Medical/Graduate: Yr.- Yr. Degree/Specialty Institution Institution City, State Residency: Yr.- Yr. Degree/Specialty Institution Institution City, State Other: Yr.- Yr. Degree/Specialty Institution Institution City, State Other: Yr.- Yr. Degree/Specialty Institution Institution City, State Other: Yr.- Yr. Degree/Specialty Institution Institution City, State</p><p>Licensure/Certifications Licensing/Certifiying Board Yr.- Yr. License/Certification # Status/Specialty Licensing/Certifiying Board Yr.- Yr. License/Certification # Status/Specialty Licensing/Certifiying Board Yr.- Yr. License/Certification # Status/Specialty Licensing/Certifiying Board Yr.- Yr. License/Certification # Status/Specialty</p><p>Practice Areas Primary practice area, secondary practice area, etc.</p><p>Professional Employment Occupation Yr.- Yr. Institution Institution City, State Occupation Yr.- Yr. Institution Institution City, State Occupation Yr.- Yr. Institution Institution City, State</p><p>Professional Affiliations, Appointments Organization Role Organization Role Organization Role Organization Role</p><p>Research Studies Protocol Title / Area of Investigation, Study Role, Yr.- Yr. Protocol Title / Area of Investigation, Study Role, Yr.- Yr. Protocol Title / Area of Investigation, Study Role, Yr.- Yr. Protocol Title / Area of Investigation, Study Role, Yr.- Yr.</p><p>Other Research Experience, Training, Affiliations, Publications, Presentations Research Training / Research Industry Affiliation / Publication Citation / Presentation Information Research Training / Research Industry Affiliation / Publication Citation / Presentation Information Research Training / Research Industry Affiliation / Publication Citation / Presentation Information</p><p>F-032.01, CV Template, 08.06.2007 Page 1 of 1</p>