21 NCAC 16B .0301. APPLICATION FOR LICENSURE

(a)  All applications shall be made on the forms furnished by the Board at www.ncdentalboard.org and no application shall be deemed complete that does not set forth all the required information.  Incomplete applications will be returned to the applicant.  Any applicant who changes his or her address shall notify the Board office within 10 business days. Applicants shall ensure that official transcripts of undergraduate college and dental school are sent in a sealed envelope to the Board office.

(b)  The nonrefundable application fee shall accompany the application.

(c)  Applicants who are licensed in other states shall ensure that the Board receives verification of licensure from the board of each state in which they are licensed.

(d)  A photograph of the applicant, taken within six months prior to the date of the application, shall be affixed to the application.

(e)  All applicants shall submit to the Board a signed release form, completed Fingerprint Record Card, and such other form(s) required to perform a criminal history check at the time of the application.  The form and card are available from the Board office.

(f)  All applicants shall arrange for and ensure the submission to the Board office the examination scores as required by Rule .0303(b) of this Subchapter, if applicable.  The examination requirement does not apply to individuals who do not hold a North Carolina dental license and who are seeking volunteer licenses pursuant to G.S. 90-21.107 or licensure by endorsement pursuant to Rules .1001 or .1002 of this Subchapter.

(g)  All applicants shall include a statement disclosing and explaining periods within the last 10 years, of any voluntary or involuntary commitment to any hospital or treatment facility, observation, assessment, or treatment for substance abuse, with verification demonstrating that the applicant has complied with all provisions and terms of any drug treatment program, or impaired dentists or other impaired professionals program.

 

History Note:        Authority G.S. 90-28; 90-30; 90-39; 90-48;

Eff. September 3, 1976;

Readopted Eff. September 26, 1977;

Amended Eff. September 1, 2014; March 1, 2006.