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Practitioner Application

Denturist Permanent Licensure Application  WORD | PDF
Written and Practical Examination Application  WORD | PDF​
Supplemental Application: Authorization to Practice through Military Training or Experience Equivalency WORD | PDF
Supplemental Application: Authorization to Practice for Military Spouse or Domestic Partner WORD |PDF​
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Denturist Training and Supervision

Supervisor Approval Application  WORD | PDF
Certification of Training and Work Experience  WORD | PDF
Temporary License Application  WORD | PDF​
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Informed Consent: Custom Teeth Whitening Tray

Informed Consent: Custom Teeth Whitening Tray  WORD | PDF​
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Required Courses, Providers

Comparable Course Content Comparison  WORD | PDF
Curriculum Objectives Modified  PDF​
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Licensee Information Update

Update Your Licensing Record Online
Customer Information Update Form  WORD
Affidavit of Licensure  WORD​
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Consumer Forms

Complaint Form  WORD
Public Records Request Form  WORD​
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