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IOWA DENTAL BOARD 400 SW 8TH ST, SUITE D DES MOINES, IA 503094687 Phone (515) 2815157 http://www.dentalboard.iowa.gov Continuing Education Record FOR BIENNIUM REPORTING PERIOD OF SEPTEMBER 1, TO AUGUST
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How to fill out iowa dental board 400
How to fill out Iowa Dental Board 400:
01
Start by obtaining a copy of the Iowa Dental Board Form 400. This form is typically available on the official website of the Iowa Dental Board or can be requested from their office.
02
Carefully read the instructions provided with the form. Make sure you understand all the requirements and information that need to be provided.
03
Begin by filling out your personal information accurately. This may include your name, address, contact details, and dental license number.
04
The next section of the form may require you to provide information about your educational background and dental training. This could include the name of the dental school you attended, graduation date, and any additional specialized training you have received.
05
You may also need to provide details about your work experience. This could include the names and addresses of any dental practices where you have worked, along with the dates of employment.
06
If applicable, disclose any past or current disciplinary actions or legal issues related to your dental practice. Be honest and thorough in this section, as failing to disclose such information could result in severe consequences.
07
Include any additional supporting documentation that may be required. This could include copies of your dental license, continuing education certificates, and any other relevant documents.
08
Review the completed form to ensure all information is accurate and complete. Double-check for any errors or omissions before submitting it to the Iowa Dental Board.
Who needs Iowa Dental Board 400:
01
Dentists in the state of Iowa who wish to apply for a dental license or renew an existing license may need to fill out Iowa Dental Board 400.
02
Dental professionals planning to relocate or change their practice location within the state may also be required to submit this form.
03
Those who have had any disciplinary actions or legal issues may need to complete Iowa Dental Board 400 as part of the review process.
04
It is essential to consult with the Iowa Dental Board or check their website to determine if you specifically need to fill out this form based on your individual circumstances.
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What is iowa dental board 400?
The Iowa Dental Board 400 is a form used for reporting certain information by dental professionals in Iowa.
Who is required to file iowa dental board 400?
Dental professionals in Iowa are required to file the Iowa Dental Board 400 form.
How to fill out iowa dental board 400?
The Iowa Dental Board 400 form can be filled out online or by mail, providing all required information accurately.
What is the purpose of iowa dental board 400?
The purpose of the Iowa Dental Board 400 form is to collect important information about dental professionals in Iowa for regulatory purposes.
What information must be reported on iowa dental board 400?
The Iowa Dental Board 400 form requires information such as personal details, practice location, education, and licenses held.
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