How does FDA's letter relate to the State approval letter that I already have?

If you have a letter or other document from a State indicating that it has approved you for MQSA work, that letter will be sufficient proof that you meet the State approval option of the requirement to be board-certified or State-licensed or State-approved. It will not, however, address whether you meet all the initial MQSA requirements. Only the letter from FDA (or if you choose not to participate in this review service, the inspector's evaluation during an inspection) covers all the initial requirements.

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