Forms

**Please note that once your application is received by the Board office,
the process takes at least 90 days.**

• Applications may be downloaded from this site using Adobe Acrobat Reader.
The Acrobat Reader can be downloaded from this site. Here's How to do this!


DENTAL PROVISIONAL, LICENSE & LICENSURE BY CREDENTIALS APPLICATIONS

Download the Dental/Provisional  License application for now

Download the Dental Licensure by Credentials application now

Download the Dental Licensure by Credentials UPDATED application now
(This application is for those applicants who have previously applied for
licensure by credentials in North Carolina.)

HYGIENE PROVISIONAL, LICENSURE EXAMINATION & LICENSURE BY CREDENTIALS APPLICATIONS

Download the Hygiene/Provisional Licensure Application  NOW
(This application is for those individuals who took or will take the CITA exam)


Download the Dental Hygiene Licensure by Credentials application now

DENTAL INTERN APPLICATIONS

Download Application for Intern Permit

Download Application for Renewal of Intern Permit
(This application is for those individuals who currently
have an intern permit in North Carolina.)

DENTAL INSTRUCTOR'S APPLICATION

Download an Instructor's Application NOW

DENTAL LIMITED VOLUNTEER APPLICATION
 

Download a Limited Volunteer Application NOW

Download a Temporary Volunteer Application NOW
 

RENEWAL APPLICATIONS

2008 DENTAL RENEWAL APPLICATION

2008 DENTAL HYGIENE RENEWAL APPLICATION

2008 GENERAL ANESTHESIA RENEWAL APPLICATION

2008 IV CONSCIOUS SEDATION RENEWAL APPLICATION

2008 INSTRUCTOR'S RENEWAL APPLICATION
 

REINSTATEMENT APPLICATIONS

  Download Application for Reinstatement (DDS)

  Download Application for Reinstatement (DH)

REQUEST FOR DUPLICATE
RENEWAL CERTIFICATE OF ORIGINAL LICENSE

  Download Request Form