ASBDE - Applications & Renewals
**New Fees Begin July 1, 2023
| Dentists |
|---|
| Dental License by Examination application |
| Dental License by Credentials 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) |
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