Licensure Applications

Complete, initial application packets for licensure are reviewed before and approved during the Board’s monthly meetings.  Once approved, applicants will receive notice by email of the approval.

Following Board approval, the jurisprudence test link will be emailed to the applicant. The jurisprudence test is given online and results are immediately available upon completion. Once the test results are verified by the licensing specialist, the license is issued and a digital copy of the license is provided via email.

*New licensees will receive their wall certificate via U.S. mail within two weeks of juris prudence test completion.

 These application forms are "fillable" but must be printed to be notarized, and must have the additional required documents and payment submitted as a complete package.

Licensing Checklist for new applicants:  

LICENSING CHECKLIST

 

          *Guidance for Dental Licensure by Regional Exam


  • Special Purpose Dental License Application to Practice Dentistry Across State Lines can be requested from Board office  The practice of dentistry “across state lines” means a dentist who is physically outside the state, treating (including rendering a documented opinion regarding diagnosis or treatment) a patient who is inside the state, via the transmission of patient data; or who is holding him/herself out to the public as being able to do so. Ala. Code 1975, § 34-9-1(12)(a). 34-9-1 is the “definitions” section.

 

  • Retired/Physically Disabled Application

Rule No. & Title: 270-X-4- .12, Waiver of Annual Registration Fees When Retired Due to Age or Physical Disability

In order to qualify for the annual registration fee waiver, the dentist or dental hygienist's retirement must be due to either "age" or "physical disability."  This Rule formalizes the procedures and standards that the Board will apply in implementing this statutory requirement.

Retired-Disabled Application 11-2023

 

  • Military/Spouse Portability Application

For dentists/hygienists who meet the qualifications of the application.

Military-Spouse License Portability Application

Special Teaching/Teaching Permit:

Special Teaching & Teaching Permit Application

 

Qualifications for Licensure Reference

Code of Alabama (1975) § 34-9-10
270-X-2.01 Education Requirements for Examination-Dentists
270-X-2.19   Licensure By Credentials
270-X-3.03 Education Requirements for Examination, Qualifications, Application, Examination and Licensure of Dental Hygienists

 

Permit Applications

Registration of 501(c)(3) Entities Operating Dental Clinics

Rule 270-X-4.10 requires that all 501(c)(3) entities register with the Board of Dental Examiners.  Please complete the form below and return it and the required supporting documents to the Board.  Please note that the form is also used for updating registrant information.  Please review Rule 4.10.

501(c)(3) Entity Registration Form

 

General Permits:

 

Controlled Substance Application:

Controlled Substance Application

 

General Anesthesia Permit:

GA Permit Application

 

Parenteral Sedation Permit:

PS Permit Application

 

Hygiene Infiltration Anesthesia Permit:

Hygiene Infiltration Permit Form

 

Oral Conscious Sedation Permit Application:

OCS Application

 

Portable Dental Operations and Mobile Dental Facilities Initial Application:

Mobile Portable Initial Application and Renewal Form

 

Forms:

Drug Dispensing Log:

Drug Dispensing Log

Drug Inventory Log:

Drug Inventory Log - Sample