Daniel E. Bluthardt, Director Division of Professional Regulation  
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Pat Quinn, Governor

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Mailing Address
Springfield Office:
320 West Washington St
Springfield, IL 62786   

Chicago Office:
James R. Thompson Ctr
100 W. Randolph St
Suite 9-300
Chicago, IL 60601   

Telephone
Springfield Office:

(217)785-0800
(217)524-6735 TDD
(217)782-7645 FAX
Chicago:
(312)814-4500

(217)782-3414 For Real Estate Calls

Dentist, Licensed



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Dentist Acceptance of Examination

    THIS PACKET INCLUDES:
    .   Instruction Sheet
    .   Licensure Methods and Definitions
    .   Elder and Child Abuse Reporting Notice
    .   Reference Sheet
    .   Application Jacket
    .   CT Certification by Licensing Agency/Board
    .   ED-DEN Certification of Education
    .   Controlled Substance Instructions and Application

 
Dentist Endorsement of License

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . CT Certification by Licensing Agency/Board . ED-DEN Certification of Education . VE-DEN Verification of Employment/Experience . Controlled Substance Instructions and Application
 
Dental Specialist Examination

THIS PACKET INCLUDES: . Notice Regarding Examination
 
Dental Specialist Acceptance of Exam - Full American Board Diplomate

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Checklist . Application Jacket . TN-DEN Certification of Training
 
Restricted Faculty License - Non-Exam

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . CT Certification of Licensure . DN-TT Certification of Appointment for Restricted Faculty License
 
Temporary Dental Training License - Non-Exam

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . CT Certification of Licensure . CA-DEN Certification of Acceptance for Specialty/Residency Training . ED-DEN Certification of Education
 
Dental Sedation Permit

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . TN-DEN Certification of Training . AF-DEN Affidavit
 
Dental Hygienist Acceptance of Examination

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . CT Certification of Licensure . ED-DEN Certification of Training
 
Dental Hygienist Endorsement

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Jacket . CT Certification of Licensure . ED-DEN Certification of Education . VE-DEN Verification of Employment/Experience
 
Dental Specialist Endorsement

THIS PACKET INCLUDES: . Instruction Sheet . Licensure Methods and Definitions . Elder and Child Abuse Reporting Notice . Reference Sheet . Application Checklist . Application Jacket . CT Certification of Licensure Agency/Board . VE Verification of Employment/Experience . TN-DEN Certification of Training
 
Dental - Controlled Substance
     
   THIS PACKET INCLUDES:
    .   Instruction Sheet
    .   Application for State Controlled substances Registration
 

 

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