This government document is issued by Composite Medical Board for use in Georgia
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https://www.google.com/url?client=internal-element-cse&cx=450907bf5042c4844&q=https://medicalboard.georgia.gov/document/form-d-primary-care-reference-form/download&sa=U&ved=2ahUKEwjctq35jJmHAxWdg_0HHaSgBiI4UBAWegQIARAB&usg=AOvVaw0M77VYr8ZyLf639sdBu0GJ&fexp=72519171,72519168