Fillable DD Form 2813, Active Duty/Reserve Forces Dental ... - DTIC - dtic
DENTIST S TELEPHONE NUMBER Include Area Code 10. DENTIST S SIGNATURE/STATE LICENSE NUMBER DD FORM 2813 SEP 2006 PREVIOUS EDITION MAY BE USED. OMB No* 0720-0022 OMB approval expires Jul 31 2009 DEPARTMENT OF DEFENSE ACTIVE DUTY/RESERVE FORCES DENTAL EXAMINATION The public reporting burden for this collection of information is estimated to average 3 minutes per response including the time for reviewing instructions ...
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