| |
Dental
Hygiene 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
Interactive Forms Below: Click
here for Interactive Forms Instructions
|
 |
Application for a Courtesy License to Practice Dentistry to Dental Hygiene, #08-0005, Revised 07/19/07. |
|
Application for Dental Hygiene License by Credentials, #08-0075, Revised 04/09/07. |
|
| Non-Interactive Forms Below: |
|
Application for Alaska Dental Hygiene License by Examination, #08-4166, Revised 04/17/07. |
|
Application
for Certificate to Administer Local Anesthetic
Agents, #08-0073,
Revised
11/09/06. |
|
Biennial Dental Hygiene License Renewal and Local Anesthetic Permit Renewal,
#08-4063, Revised 10/25/07. |
|
|
|
 |
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. |
|
