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Dental
Applications
IMPORTANT INFORMATION:
Professional Background Information Services has changed
their address to the following.
Professional Background Information Services
9201 North 25th Avenue, Suite 130
Phoenix, Arizona 85021
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Application for a Courtesy License to Practice Dentistry to Dental Hygiene, #08-0005, Revised 07/19/07. |
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Application
for Dental Licensing by Credentials, #08-4159,
Revised 5/10/2004. |
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Application for Dental License by Examination Level II, #08-0074, Revised 04/18/07. |
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Application for Dental License by Examination Level III, #08-4165, Revised 04/18/07. |
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Application
for Licensure as a Dental Specialty License
and General Anesthetic Permit Application,
#08-0006, Revised 04/18/07. This form may be
completed online with Adobe Acrobat 5.0 or
higher, then printed and mailed. |
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Application
for Obtaining a Permit to Administer Parenteral
Sedation, #08-4172, Revised 07/13/07. |
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Biennial Dental License Renewal, #08-4132, Revised 09/20/06. |
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Branch
Office Application, #08-4184, Revised 07/16/07. |
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Applications
may be
viewed and printed
with Adobe
Acrobat
Reader
6.0 or
higher. If you
do
not have
Adobe Acrobat
Reader
6.0 or higher,
please
click
on the
Adobe logo and
download
the free
software
now. If
you
are unable
to view
or download
an application,
please
contact us by
telephone
or e-mail.
Providing
your complete
mailing
address will
enable
us to mail
you the
application. Other
application
forms
may be mailed
to you
or picked up
at a
division
office.
Completed applications
must
be signed
and submitted
to the
division with
the
appropriate
fees. |
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