DENTIST |
| Initial Application (by NERB Examination) |
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| Initial Application (Licensed in another state) |
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| Initial Limited Dental - Graduate of U.S. or Canadian Dental School |
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Initial Application for a Teacher’s License – Dentistry/ Dental Hygiene |
DOWNLOAD |
| Initial Limited Dental - Graduate of Foreign Dental School |
DOWNLOAD |
| Initial Application for Foreign Trained Dentists- University of Maryland Dental School Faculty by Examination |
DOWNLOAD
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| Dental Pediatric Fellow |
DOWNLOAD
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Dental Volunteer Application |
DOWNLOAD
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Dentist Temporary Volunteer Application |
DOWNLOAD |
| Retired Volunteer Application |
DOWNLOAD
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| Reinstatement of Dental License |
DOWNLOAD
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| Ownership of a Dental Practice |
Download |
| Specialty Application |
DOWNLOAD
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| Full Drug Dispensing Permit Application |
DOWNLOAD
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| Limited Drug Dispensing Permit Application |
DOWNLOAD |
| Expert Witness Application |
Download |
| Application to Participate In An Advanced Clinical Training Program For Continuing Education At The University of Maryland Dental School |
DOWNLOAD
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2020 DENTIST RENEWAL APPLICATION -Fillable
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DOWNLOAD
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2021 DENTIST RENEWAL APPLICATION - Fillable |
DOWNLOAD
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2022 Dentist CE Audit Form - New
|
Download |
| DENTAL HYGIENIST |
| Initial Application (by ADEX/NERB Examination) |
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Initial Application (Licensed in another state) |
DOWNLOAD
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| Dental Hygienist Temporary Volunteer Application |
DOWNLOAD
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| Dental Hygienist Volunteer Application |
Download |
Dental Hygiene Waiver of Supervision |
Download |
| Applicant (NOT Recognized) to Administer Local Anesthesia (BLOCK) in another state |
Download
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| Applicant (Recognized) to Administer Local Anesthesia (BLOCK) in another state |
DOWNLOAD
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| Applicant (Recognized) to Administer Nitrous Oxide |
DOWNLOAD
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| Applicant (Recognized) to Administer Nitrous Oxide in another state |
DOWNLOAD
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2020 DENTAL HYGIENE RENEWAL APPLICATION - Fillable |
DOWNLOAD |
2021 DENTAL HYGIENE RENEWAL APPLICATION - Fillable
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DOWNLOAD |
2022 Dental Hygiene CE Audit Form- New
| DOWNLOAD
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DENTAL RADIATION TECHNOLOGIST |
| Initial Dental Radiation Technologist by Waiver |
Download
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| Initial Dental Radiation Technologist by Examination |
Download |
| Initial Qualified Dental Assistant- General |
Download
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| Initial Qualified Dental Assistant- Orthodontics |
Download
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| Reinstatement of a Dental Radiation Technologist Certification |
Download |
2022 Dental Radiation Technologist Renewal Application
| Download |
2022 Dental Radiation Technologist Renewal Instructions
| Download |
SEDATION PERMITS |
| Application for Anesthesia and Sedation Permits and Certificates |
Download
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| 2021 Anesthesia Permit- Certification Renewal |
Download
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| 2021 Anesthesia Permit- Certification Renewal Affidavit |
Download
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MISCELLANEOUS FORMS |
| Photo Affidavit- All license types |
Download |
| Change of Information (Name, Address, etc.) |
Download |
| Roster Request Form- Updated |
Download
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Reactivation of an Inactive License- Dentist & Hygienist |
DOWNLOAD |
Reinstatement of Expired License- Dentist, Dental Hygienist, Dental Teacher |
Download |
| Application for Corporate Name |
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| Continuing Education Extension Request Form |
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