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Texas State Board of Dental Examiners2x2 Passport Photo1801 Congress Avenue, Suite 8,600
Austin, Texas 78701
(512) 4636400 / Fax: (512) 6491658RequiredPLACE HEREReinstate a Retired Dental LicenseInstructions:
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Write the current date in the top right corner of the check.
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Make Your Check or is a form that individuals or businesses must fill out to report their income and make any necessary tax payments.
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