2022 AAD ERG LGBTQ Resident Panel Oct 25
Registration for the 2022 AAD ERG LGBTQ Resident Panel on Tuesday, October 25th from 8:30pm -9:30pm EST

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Medical School or Residency Program
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What questions or concerns would you like our panelists to address?
Would you be interested in being part of a LGBTQ+ dermatology community for medical students? *
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