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Forms

Duplicate License

Download the duplicate request form to order copies of your license, renewal certificate and sedation certificate. 

Name Change

Update your new name with the Board.

Address Change

Click here to update your mailing or practice address. 

Restorative Functions 

Download the restorative functions certificate application form. 

Renewal Forms 

Print renewal forms not currently available through online renewal. (All other licenses shall renew online) 

Recordkeeping Checklist

Click here to access the checklist for self-audit of compliance with the Board's recordkeeping rule. 

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