**New Fees Begin July 1, 2023
Dentists
- Dental License by Examination application
- Arkansas Specialty application
- License Reinstatement form
- Moderate Sedation Permit
- General/deep Sedation Permit
- Mobile Dental Facility permit
- Collaborative Care Permit application (note: must be approved by the Arkansas Department of Health’s Office of Oral Health before applying with the Board. Contact the Office of Oral Health at 501-280-4111 for more information.)
- Dental Corporation/Limited Liability Company Registration form
- Fictitious Name Request form
- Wall Certificate Remake form
- Verification of Licensure Request form
- Change Request form (to request a name, address, phone number, or email change)
Hygienists
- Dental Hygiene License by Examination application
- Dental Hygiene License by Credentials application
- License Reinstatement form
- Collaborative Care Permit application (note: must be approved by the Arkansas Department of Health’s Office of Oral Health before applying with the Board. Contact the Office of Oral Health at 501-280-4051 for more information.)
- Local Anesthesia Permit application
- Wall Certificate Remake
- Verification of License Request form
- Change Request form (to request a name, address, phone number, or email change)
Assistants
- Application for Registration of Dental Assistants
- Expanded Duties Add-On for Registered Dental Assistants
- Verification of Licensure Request form
- Wall Certificate Remake
- Change Request form (to request a name, address, phone number, or email change)
