Common Contracts
1 similar Dental Hygiene Collaborative Agreement contracts
State of AlaskaDepartment of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing BOARD OF DENTAL EXAMINERSState Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK...Dental Hygiene Collaborative Agreement • May 22nd, 2018
It is the responsibility of the applicant to ensure that all information requested in this application is received. Each question must be answered fully, truthfully, and accurately. Any omissions or inaccuracies are grounds for disapproval and rejection. AS 08.32.160(1) of the Dental Hygiene Practice Act provides that knowingly cooperating in deceit, fraud, or intentional misrepresentation to obtain a license is cause for suspension, revocation, or annulment of licensure. If the space for any answer is insufficient, the applicant may complete his/her answer on another sheet signed by him/her and specifying the number of the question to which it relates.
