D.C. Mun. Regs. tit. 17, r. 17-10706

Current through Register Vol. 71, No. 50, December 13, 2024

Rule 17-10706 - APPLICATION FOR AN INDIVIDUAL DENTAL CERTIFICATION TO ADMINISTER SEDATION OR GENERAL ANESTHESIA

10706.1

To apply for a Class I, Class II, or Class III Individual dental certification, an applicant shall:

(a) Submit a completed application to the Board on the required forms and include:

(1) The applicant's social security number on the application;

(2) Two (2) recent passport-type photographs of the applicant's face measuring two inches by two inches (2" x 2") which clearly expose the area from the top of the forehead to the bottom of the chin

(b) Submit a copy of his or her current license with the application;

(c) Submit the name and address of each location where the dentist intends to administer anesthesia or sedation;

(d) Identify all forms of anesthesia or sedation for which the dentist is seeking certification;

(e) Submit proof of having successfully passed the clinical evaluation required by § 10705 of this chapter.

(f) Pay all the required fees; and

(g) Submit all required supporting documents.

D.C. Mun. Regs. tit. 17, r. 17-10706

Final Rulemaking published at 67 DCR 8806 (7/17/2020)