Dentists Dental Licensure Application Dentist Temporary Licensure for Charitable Purpose Change of Address Name Change Request Duplicate Renewal License Verification of Licensure Request Designation of Records Board Scores Wall License Replacement Clinical Affidavit N2O & Level 1 Anesthesia Affidavit Level 2-4 Anesthesia Affidavit Hygienists Dental Hygiene Licensure Application Change of Address Name Change Request Duplicate Renewal License Name Change Request Duplicate Renewal License Verification of Licensure or Registration Board Scores Wall License Replacement Clinical Affidavit Dental Assistants Change of Address Name Change Request Verification of Certificate or Registration Duplicate Renewal License Dental Laboratories Change of Address Change the Certified Dental Technician of Record Closure Notification Mobile Facilities Change of Address – 2021 Duplicate Registration Certificate
