North Carolina State Board of Dental Examiners

forms

Please note that once your application is received by the Board office, the process takes at least 90 days.

Dental Provisional, License & Licensure by Credentials Applications

Download the Dental/Provisional License application
(This application is for thos individuals who took or will take the CITA exam)

Hygiene Provisional, Licensure Examination & Licensure by Credentials Applications

Download the Hygiene/Provisional Licensure Application
(This application is for thos individuals who took or will take the CITA exam)

Dental Intern Applications

Download Application for Renewal of Intern Permit
(This application is for those individuals who currently have an intern permit in North Carolina.)

Dental Instructor's Application

Dental Limited Volunteer Application

Anesthesia & Sedation Permits

Reinstatement Applications

Professional Corporations

Request for Duplicate Dental Original License

Request for Certificate of Licensure

Download Certificate of Licensure Request Form
(Official mailed verification or Letter of Good Standing for Licensure in another State) - Fee required

Dental Laboratory & Subcontractor Work Order Forms

Functions of the Board of Dental Examiners

	The administration of licensure examinations for dentists and dental hygienists

	The promulgation of rules and enforcement of laws and regulations governing the practice of dentistry and dental hygiene in this state

	The issuance and renewal of licenses to dentists and dental hygienists