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Board of Dental Examiners
State of Alaska > Commerce > Professional Licensing   > Dental Examiners >License Renewal Applications
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License Renewal Applications
Biennial Dental License Renewal, #08-4132, Revised 10/24/12.
Biennial Dental Hygiene License Renewal, Local Anesthetic Permit Renewal and Restorative Function Endorsement Renewal, #08-4063, Revised 10/24/12.
Biennial Dental Assistant Coronal Polishing Certificate Renewal, #08-4610, Revised 10/24/12.
Biennial Dental Assistant Restorative Function Certificate Renewal, #08-4609, Revised 10/24/12.
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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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