ASBDE - Applications & Renewals
**New Fees Begin July 1, 2023
Dentists |
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Dental License by Examination application |
Dental License by Credentials application |
Arkansas Specialty application |
License Reinstatement form |
Moderate Sedation Permit |
General/deep Sedation Permit |
Mobile Dental Facility permit |
Collaborative Care Permit application (note: must be approved by the Arkansas Department of Health's Office of Oral Health before applying with the Board. Contact the Office of Oral Health at 501-280-4111 for more information.) |
Dental Corporation/Limited Liability Company Registration form |
Fictitious Name Request form |
Wall Certificate Remake form |
Verification of Licensure Request form |
Change Request form (to request a name, address, phone number, or email change) |
Hygienists |
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Dental Hygiene License by Examination application |
Dental Hygiene License by Credentials application |
License Reinstatement form |
Collaborative Care Permit application (note: must be approved by the Arkansas Department of Health's Office of Oral Health before applying with the Board. Contact the Office of Oral Health at 501-280-4051 for more information.) |
Local Anesthesia Permit application |
Wall Certificate Remake |
Verification of License Request form |
Change Request form (to request a name, address, phone number, or email change) |
Assistants |
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Application for Registration of Dental Assistants |
Expanded Duties Add-On for Registered Dental Assistants |
Verification of Licensure Request form |
Wall Certificate Remake |
Change Request form (to request a name, address, phone number, or email change) |