Below are the links to the forms for the applicable applications. These forms will need to be downloaded, filled out and submitted with the application or as instructed. You may submit the forms in the Uploads sections of the application or mail in to our office. Electronic applications allow you to make payment via Visa/Mastercard or e-check.
Please select the appropriate application documents link to download the form(s) before beginning the electronic application.
- Click here to begin the electronic application
- Dental License
- Sedation Permit
- Dental Hygiene License
- Restricted Instructor
- Restricted Volunteer License
- Dental/Orthodontic Technician Registration
- Mobile Dental Facility and Portable Dental Operation Registration
Reinstatement of License/Certification
- 2020 Dental Renewal Form - General/Specialty/Instructor/Volunteer
- 2020 Dental Hygiene Renewal Form - General/ License with IA Certification/Instructor/Volunteer
- 2020 Dental and Orthodontic Technician Renewal Form Volunteer
- CPR and CE Waiver Form