<label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">Last Name</label> | <input name="dnn$ctr865$Search$txtlastName" type="text" value="hackenberg" id="dnn_ctr865_Search_txtlastName" tabindex="1" class="wide-box-search" style="width: 175px; border: 1px solid rgb(153, 153, 153); height: auto; color: rgb(102, 102, 102); margin: 0px 0px 0px 4px; padding: 3px; float: left;"> | <label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">First Name</label> | <input name="dnn$ctr865$Search$txtfirstName" type="text" value="thomas" id="dnn_ctr865_Search_txtfirstName" tabindex="2" class="wide-box-search" style="width: 175px; border: 1px solid rgb(153, 153, 153); height: auto; color: rgb(102, 102, 102); margin: 0px 0px 0px 4px; padding: 3px; float: left;"> |
<label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">City</label> | <input name="dnn$ctr865$Search$txtCity" type="text" value="colorado springs" id="dnn_ctr865_Search_txtCity" tabindex="3" class="wide-box-search" style="width: 175px; border: 1px solid rgb(153, 153, 153); height: auto; color: rgb(102, 102, 102); margin: 0px 0px 0px 4px; padding: 3px; float: left;"> | <label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">State/Province</label> | <select name="dnn$ctr865$Search$ddlState" id="dnn_ctr865_Search_ddlState" tabindex="4" class="wide-box-search" style="width: 175px; border-color: rgb(153, 153, 153); height: auto; color: rgb(102, 102, 102); margin: 0px 0px 0px 4px; padding: 3px; float: left;"> <option value="[Select]">[Select]</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AB">Alberta</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="AE">Armed Forces</option> <option value="AA">Armed Forces Americas</option> <option value="AP">Armed Forces Pacific</option> <option value="BI">Bitnar</option> <option value="BC">British Columbia</option> <option value="CA">California</option> <option selected="selected" value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="DF">Districto Federal</option> <option value="FM">Federated States of Micronesia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="JA">Jalisco</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MB">Manitoba</option> <option value="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MX">Mexico</option> <option value="MI">Michigan</option> <option value="MG">Minas Gerais</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NB">New Brunswick</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NF">Newfoundland</option> <option value="NL">Newfoundland and Labrador</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="MP">Northern Mariana Islands</option> <option value="NT">Northwest Territory</option> <option value="NS">Nova Scotia</option> <option value="NU">Nunavut</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="ON">Ontario</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PE">Prince Edward</option> <option value="PR">Puerto Rico</option> <option value="QC">Quebec</option> <option value="RI">Rhode Island</option> <option value="RJ">Rio de Janeiro</option> <option value="SP">Sao Paulo</option> <option value="SK">Saskatchewan</option> <option value="SO">Sinaloa</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VI">Virgin Islands</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WU">Western Australia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value="YK">Yukon</option> <option value="ZA">Zacatecas</option> </select> |
<label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">Zip Code</label> | <input name="dnn$ctr865$Search$txtZipCode" type="text" value="80920" id="dnn_ctr865_Search_txtZipCode" tabindex="4" class="input-box-search" style="width: 100px; border: 1px solid rgb(153, 153, 153); height: 16px; color: rgb(102, 102, 102); margin: 0px 0px 5px 4px; padding: 3px; float: left;"> | <label class="search-form-field-labels" style="height: 18px; font-size: 0.8em; margin: 0px; padding: 3px; text-align: right; width: 65px; float: left;">Specialty</label> | <select name="dnn$ctr865$Search$ddlcertification" id="dnn_ctr865_Search_ddlcertification" tabindex="6" class="wide-box-search" style="width: 175px; border-color: rgb(153, 153, 153); height: auto; color: rgb(102, 102, 102); margin: 0px 0px 0px 4px; padding: 3px; float: left;"> <option value="[Select]">[Select]</option> <option value="146">Addiction Psychiatry</option> <option value="77">Adolescent Medicine</option> <option value="203">Adult Congenital Heart Disease</option> <option value="185">Advanced Heart Failure and Transplant Cardiology</option> <option value="45">Aerospace Medicine</option> <option value="41">Allergy & Immunology</option> <option value="9">Anatomic Pathology</option> <option value="8">Anatomic Pathology & Clinical Pathology</option> <option value="35">Anesthesiology</option> <option value="207">Anesthesiology Critical Care Medicine</option> <option value="108">Blood Banking</option> <option value="107">Blood Banking/Transfusion Medicine</option> <option value="201">Brain Injury Medicine</option> <option value="80">Cardiac Electrophysiology</option> <option value="78">Cardiovascular Disease</option> <option value="109">Chemical Pathology</option> <option value="147">Child & Adolescent Psychiatry</option> <option value="178">Child Abuse Pediatrics</option> <option value="148">Child Psychiatry</option> <option value="62">Clinical & Laboratory Immunology</option> <option value="66">Clinical & Laboratory Dermatological Immunology</option> <option value="170">Clinical & Laboratory Immunology</option> <option value="51">Clinical Biochemical Genetics</option> <option value="52">Clinical Biochemical/Molecular Genetics</option> <option value="79">Clinical Cardiac Electrophysiology</option> <option value="53">Clinical Cytogenetics</option> <option value="54">Clinical Genetics</option> <option value="202">Clinical Informatics</option> <option value="55">Clinical Molecular Genetics</option> <option value="149">Clinical Neurophysiology</option> <option value="10">Clinical Pathology</option> <option value="5">Colon & Rectal Surgery</option> <option value="196">Complex General Surgical Oncology</option> <option value="187">Congenital Cardiac Surgery</option> <option value="64">Critical Care Medicine</option> <option value="110">Cytopathology</option> <option value="67">Dermatological Immunology/Diagnostic and Laboratory Immunology</option> <option value="2">Dermatology</option> <option value="68">Dermatopathology</option> <option value="123">Developmental-Behavioral Pediatrics</option> <option value="27">Diagnostic & Medical Nuclear Physics</option> <option value="63">Diagnostic Laboratory Immunology</option> <option value="28">Diagnostic Medical Physics</option> <option value="16">Diagnostic Radiology</option> <option value="17">Diagnostic Radiology with Special Competence in Nuclear Radiology</option> <option value="18">Diagnostic Roentgenology</option> <option value="188">Emergency Medical Services</option> <option value="4">Emergency Medicine</option> <option value="84">Endocrinology and Metabolism</option> <option value="85">Endocrinology, Diabetes and Metabolism</option> <option value="189">Epilepsy</option> <option value="40">Family Medicine</option> <option value="195">Female Pelvic Medicine and Reconstructive Surgery</option> <option value="112">Forensic Pathology</option> <option value="150">Forensic Psychiatry</option> <option value="86">Gastroenterology</option> <option value="46">General Preventive Medicine</option> <option value="74">Geriatric Medicine</option> <option value="171">Geriatric Psychiatry</option> <option value="100">Gynecologic Oncology</option> <option value="88">Hematology</option> <option value="176">Hospice and Palliative Medicine</option> <option value="114">Immunopathology</option> <option selected="selected" value="89">Infectious Disease</option> <option value="39">Internal Medicine</option> <option value="205">Internal Medicine - Critical Care Medicine</option> <option value="90">Interventional Cardiology</option> <option value="206">Interventional Radiology and Diagnostic Radiology</option> <option value="101">Maternal-Fetal Medicine</option> <option value="193">Medical Biochemical Genetics</option> <option value="115">Medical Microbiology</option> <option value="91">Medical Oncology</option> <option value="70">Medical Toxicology</option> <option value="96">Molecular Genetic Pathology</option> <option value="125">Neonatal-Perinatal Medicine</option> <option value="92">Nephrology</option> <option value="126">Neurodevelopmental Disabilities</option> <option value="50">Neurological Surgery</option> <option value="13">Neurology</option> <option value="14">Neurology with Special Qualification in Child Neurology</option> <option value="174">Neuromuscular Medicine</option> <option value="117">Neuropathology</option> <option value="172">Neuroradiology</option> <option value="104">Neurotology</option> <option value="29">Nuclear Medical Physics</option> <option value="12">Nuclear Medicine</option> <option value="19">Nuclear Medicine Medallion</option> <option value="155">Nuclear Radiology</option> <option value="42">Obstetrics & Gynecology</option> <option value="47">Occupational Medicine</option> <option value="15">Ophthalmology</option> <option value="167">Orthopaedic Sports Medicine</option> <option value="37">Orthopaedic Surgery</option> <option value="43">Otolaryngology</option> <option value="65">Pain Medicine</option> <option value="198">Pathology - Anatomic</option> <option value="197">Pathology - Anatomic/Pathology - Clinical</option> <option value="179">Pathology - Chemical</option> <option value="199">Pathology - Clinical</option> <option value="180">Pathology - Forensic</option> <option value="181">Pathology - Hematology</option> <option value="182">Pathology - Medical Microbiology</option> <option value="183">Pathology - Molecular Genetic</option> <option value="184">Pathology - Pediatric</option> <option value="61">Pathology Recertification</option> <option value="194">Pediatric Anesthesiology</option> <option value="127">Pediatric Cardiology</option> <option value="128">Pediatric Critical Care Medicine</option> <option value="69">Pediatric Dermatology</option> <option value="129">Pediatric Emergency Medicine</option> <option value="130">Pediatric Endocrinology</option> <option value="131">Pediatric Gastroenterology</option> <option value="132">Pediatric Hematology-Oncology</option> <option value="133">Pediatric Infectious Diseases</option> <option value="134">Pediatric Nephrology</option> <option value="105">Pediatric Otolaryngology</option> <option value="118">Pediatric Pathology</option> <option value="135">Pediatric Pulmonology</option> <option value="156">Pediatric Radiology</option> <option value="140">Pediatric Rehabilitation Medicine</option> <option value="136">Pediatric Rheumatology</option> <option value="158">Pediatric Surgery</option> <option value="192">Pediatric Transplant Hepatology</option> <option value="177">Pediatric Urology</option> <option value="11">Pediatrics</option> <option value="56">Ph.D. Medical Genetics</option> <option value="38">Physical Medicine & Rehabilitation</option> <option value="44">Plastic Surgery</option> <option value="106">Plastic Surgery within the Head and Neck</option> <option value="7">Psychiatry</option> <option value="169">Psychosomatic Medicine</option> <option value="48">Public Health</option> <option value="49">Public Health & General Preventive Medicine</option> <option value="93">Pulmonary Disease</option> <option value="20">Radiation Oncology</option> <option value="34">Radiation Oncology Recertification</option> <option value="119">Radioisotopic Pathology</option> <option value="22">Radiologic Physics</option> <option value="21">Radiology</option> <option value="23">Radium Therapy</option> <option value="102">Reproductive Endocrinology/Infertility</option> <option value="94">Rheumatology</option> <option value="24">Roentgen & Gamma Physics</option> <option value="25">Roentgenology</option> <option value="175">Sleep Medicine</option> <option value="138">Spinal Cord Injury Medicine</option> <option value="72">Sports Medicine</option> <option value="36">Surgery</option> <option value="103">Surgery of the Hand</option> <option value="159">Surgical Critical Care</option> <option value="30">Therapeutic & Diagnostic Radiologic Physics</option> <option value="31">Therapeutic & Medical Nuclear Physics</option> <option value="32">Therapeutic Medical Physics</option> <option value="33">Therapeutic Radiology</option> <option value="57">Therapeutic Roentgenology</option> <option value="200">Thoracic and Cardiac Surgery</option> <option value="1">Thoracic Surgery</option> <option value="173">Transplant Hepatology</option> <option value="73">Undersea & Hyperbaric Medicine</option> <option value="145">Undersea Medicine</option> <option value="3">Urology</option> <option value="157">Vascular & Interventional Radiology</option> <option value="168">Vascular Neurology</option> <option value="161">Vascular Surgery</option> <option value="26">X-Ray and Radium Physics</option> </select> |