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LARA/LDN-506 09/12 Michigan Department of Licensing and Regulatory Affairs Board of Dentistry P. O. Box 30670 Lansing Michigan 48909 517 335-0918 www. michigan*gov/healthlicense DENTAL ASSISTANT LICENSURE INSTRUCTIONS Authority P. A. 368 of 1978 as amended This form is for information only. NOTE It is your responsibility to have all required documentation sent to the Board of Dentistry. Questions regarding your application can be directed to the Michigan Board of Dentistry at 517 335-0918...
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How to fill out LARA/LDN-506 (09/12)
01
Obtain the LARA/LDN-506 form from the appropriate source.
02
Fill in your personal information at the top section of the form.
03
Provide relevant details about the program or service you are applying for.
04
Complete any additional sections that require specific information related to your application.
05
Review the form for accuracy and completeness.
06
Sign and date the form at the designated area.
07
Submit the form according to the provided instructions (mail, email, or online submission).
Who needs LARA/LDN-506 (09/12)?
01
Individuals or organizations applying for licenses or permits related to specific services regulated by LARA.
02
Professionals who require compliance with state regulations in Michigan.
03
Anyone needing to document information for regulatory purposes in their field of practice.
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What is LARA/LDN-506 (09/12)?
LARA/LDN-506 (09/12) is a form used for reporting specific information to the Michigan Department of Licensing and Regulatory Affairs (LARA) regarding certain business activities.
Who is required to file LARA/LDN-506 (09/12)?
Businesses and individuals engaged in activities that fall under the regulatory purview of LARA are required to file LARA/LDN-506 (09/12). This typically includes licensed professionals and registered entities within the jurisdiction.
How to fill out LARA/LDN-506 (09/12)?
To fill out LARA/LDN-506 (09/12), applicants must provide accurate and complete information as outlined in the form's instructions, including entity details, identification numbers, and specific activity data.
What is the purpose of LARA/LDN-506 (09/12)?
The purpose of LARA/LDN-506 (09/12) is to ensure compliance with state regulations by collecting necessary data that supports monitoring and enforcement of laws pertaining to various licensed activities.
What information must be reported on LARA/LDN-506 (09/12)?
The form requires reporting information such as the legal name of the entity, contact information, type of business, license numbers, and details regarding specific transactions or activities as mandated by LARA.
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