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Online Complaint Form

Please use the form below to submit a complaint electronically. NOTE: You will NOT be able to save and exit. Please be sure to complete the form and press 'Submit' before exiting the page. 
The Board can only take action against the license of a Dentist, Dental Hygienist, or Dental Assistant license. The Board can only act against the license of individuals licensed with this Board (disciplinary or corrective action). The Board can't help if you are only seeking monetary refund for services you had performed. The Board does not accept complaints against unlicensed individuals (for example; dental office managers, receptionists) unless they are related to the unlicensed practice of dentistry. Complaints must be filed on a licensee in all other matters. Have questions before you consider filing a complaint? Please email
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