Application Checklist

For Applicants who have graduated with a Doctor of Dental Surgery, or Doctor of Dental Medicine Degree from an accredited University. The applicant must have taken and passed the clinical exam less than five (5) years ago. Use this section to ensure you've submitted all requirements.

1. Completed Application: Submit an application online
2. Application fee of $250.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable): Documentation may include a copy of your marriage certificate or divorce decree.
6. Official Transcripts: Applicants must upload an official transcript obtained from the University. The transcripts from which you obtained your degree must show that all requirements for graduation have been met and the date the degree was conferred.
7. Certificate of Completion: Applicants must submit a completed Certificate of Completion completed and signed by the dean of applicant’s professional school and registrar of the university or college.
8. Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) Card: Applicants are required to submit a copy of your current BLS and/or ACLS certification card.
9. Examination Requirements
   • National Board Examination: An official score report from the National Board Dental Examinations, sent directly to the Board from the National Boards, showing passing scores in all sections of the examination. Information on how to obtain your score report and fee information can be obtained by going to their website. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted.
   • Clinical Examination: An applicant must pass all parts of one (1) of the following examinations. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted. Please have your score report sent directly to the Board from one of the entities listed below:
     • Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org
     • Central Regional Dental Testing Service Examination (CRDTS)
       Website: www.crdts.org
     • Southern Regional Testing Agency (SRTA)Website: www.srta.org
10. Verification of State Licensure (if applicable): If you hold a license or certification in another State, you must provide verification of that information. Verifications must be completed from the state of issuance and can be uploaded to your online account.  Those jurisdictions may provide their own verification, or complete our verification form here. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure.
    
    The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
11. National Practitioner Data Bank (if applicable): Applicants who are now or have been licensed to practice dentistry in another state or jurisdiction must submit a report from the National Practitioner Data Bank (NPDB). Please contact the NPDB to request a self-query report. All self-query report applications must be requested electronically through the NPDB website listed below. Information on how to complete a self-query is located on the website. Please review this helpful information on how to obtain your report. Once you receive your NPDB report, please forward the report to the Professional Licensing Agency.

National Practitioner Data Bank
P.O. Box 10832
Chantilly, Virginia 20153-0832
Website: www.npdb.hrsa.gov
Customer Service Center: 1-800-767-6732
Email: help@npdb.hrsa.gov

11. Jurisprudence Examination: Once all above items have been reviewed and approved, the applicant will be sent a jurisprudence exam by email. All applicants for dental licensure are required to pass a jurisprudence examination. No applicant is exempt from this requirement. You will have fourteen (14) days from the date the email is sent to you in order to complete the examination and return the required information to our office. All applicants will be examined on the Statute and Rules of Indiana related to the practice of dentistry and dental hygiene, universal precautions, and infectious wastes. This is a 30 question true-false and multiple-choice examination. Passing criteria is 75%. Statutes and Administrative Rules are available on the Resources page. The jurisprudence examination is based on the following:

Ind. Code 25-13 Dental Hygiene Law
Ind. Code 25-14 Dental Law
Ind. Code 25-1 Professional Licensing Agency General Provisions
Title 828 IAC Dental and Dental Hygiene Rules
Title 410 IAC 1-3 and 1-4 Infectious Waste and Universal Precaution

Application Checklist

For Applicants who currently hold an Active license in another State. Your license must be an equivalent dental license, and not show discipline against the license. If your license has been disciplined, your application will need to be reviewed by the Board prior to issuance. Use this section to ensure you've submitted all requirements.

1. Completed Application: Submit an application online.
2. Application fee of $250.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable):  Documentation may include a copy of your marriage certificate or divorce decree.
6. Verification of State Licensure: You must provide verification the license(s) or certification in another State. Verifications must be completed from the state of issuance and can be uploaded to your online account. Those jurisdictions may provide their own verification. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure. You must provide verification of all licenses that you have held.
   
   Your state may complete our verification form here. The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
7. Jurisprudence Examination: Once all above items have been reviewed and approved, the applicant will be sent a jurisprudence exam by email. All applicants for dental licensure are required to pass a jurisprudence examination. No applicant is exempt from this requirement. You will have fourteen (14) days from the date the email is sent to you in order to complete the examination and return the required information to our office. All applicants will be examined on the Statute and Rules of Indiana related to the practice of dentistry and dental hygiene, universal precautions, and infectious wastes. This is a 30 question true-false and multiple-choice examination. Passing criteria is 75%. Statutes and Administrative Rules are available on the Resources page. The jurisprudence examination is based on the following:

Ind. Code 25-13 Dental Hygiene Law
Ind. Code 25-14 Dental Law
Ind. Code 25-1 Professional Licensing Agency General Provisions
Title 828 IAC Dental and Dental Hygiene Rules
Title 410 IAC 1-3 and 1-4 Infectious Waste and Universal Precaution

Application Checklist

For Applicants who have graduated from a Unaccredited College. Use this section to ensure you've submitted all requirements.

1. Completed Application: Submit an application online.
2. Application fee of $250.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable):  Documentation may include a copy of your marriage certificate or divorce decree.
6. Transcripts:  The applicant must submit a transcript of the applicant’s dental education, including the degree conferred and the date the degree was conferred. If the transcript is in a language other than English, the applicant must include a certified translation of the transcript. If an original transcript is not available, the applicant must submit an affidavit fully and clearly stating the reasons that an original transcript is not available.
7. Clinical Training Program: Applicants must have successfully completed a clinical training program of at least two (2) years and submit an official transcript. The applicant must show completion of one of the following:
   (a) An accredited institution that reasonably ensures a level of competency equal to that of graduates of accredited dental colleges, as determined by the board.
   (b) A general practice residency program at an accredited institution.
   (c) Advanced education in a general dentistry program from an accredited institution.
8. Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) Card: Applicants are required to submit a copy of your current BLS and/or ACLS certification card.
9. Examination Requirements
   • National Board Examination: An official score report from the National Board Dental Examinations, sent directly to the Board from the National Boards, showing passing scores in all sections of the examination. Information on how to obtain your score report and fee information can be obtained by going to their website. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted.
   • Clinical Examination: An applicant must pass all parts of one (1) of the following examinations. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted. Please have your score report sent directly to the Board from one of the entities listed below:
     • Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org
     • Central Regional Dental Testing Service Examination (CRDTS)
       Website: www.crdts.org
     • Southern Regional Testing Agency (SRTA)Website: www.srta.org
10. Verification of State Licensure (if applicable): If you hold a license or certification in another State, you must provide verification of that information. Verifications must be completed from the state of issuance and can be uploaded to your online account.  Those jurisdictions may provide their own verification, or complete our verification form here. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure.
    
    The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
11. National Practitioner Data Bank (if applicable): Applicants who are now or have been licensed to practice dentistry in another state or jurisdiction must submit a report from the National Practitioner Data Bank (NPDB). Please contact the NPDB to request a self-query report. All self-query report applications must be requested electronically through the NPDB website listed below. Information on how to complete a self-query is located on the website. Please review this helpful information on how to obtain your report. Once you receive your NPDB report, please forward the report to the Professional Licensing Agency.

National Practitioner Data Bank
P.O. Box 10832
Chantilly, Virginia 20153-0832
Website: www.npdb.hrsa.gov
Customer Service Center: 1-800-767-6732
Email: help@npdb.hrsa.gov

12. English Proficiency Exam: The applicant must pass the Test of English as a Foreign Language (TOEFL) and submit proof of such to the Board.
    Note: According to IC 25-14-1-4.5(b), the Board, at its discretion, may waive the requirements of the English proficiency examination. If you are requesting a waiver, please provide a statement listing the details of your request.
13. Jurisprudence Examination: Once all above items have been reviewed and approved, the applicant will be sent a jurisprudence exam by email. All applicants for dental licensure are required to pass a jurisprudence examination. No applicant is exempt from this requirement. You will have fourteen (14) days from the date the email is sent to you in order to complete the examination and return the required information to our office. All applicants will be examined on the Statute and Rules of Indiana related to the practice of dentistry and dental hygiene, universal precautions, and infectious wastes. This is a 30 question true-false and multiple-choice examination. Passing criteria is 75%. Statutes and Administrative Rules are available on the Resources page. The jurisprudence examination is based on the following:

Ind. Code 25-13 Dental Hygiene Law
Ind. Code 25-14 Dental Law
Ind. Code 25-1 Professional Licensing Agency General Provisions
Title 828 IAC Dental and Dental Hygiene Rules
Title 410 IAC 1-3 and 1-4 Infectious Waste and Universal Precaution

Application Checklist

For Applicants who have graduated with an Associate Degree in Dental Hygiene from an accredited University. The applicant must have taken and passed the clinical exam less than five (5) years ago. Use this section to ensure you've submitted all requirements.

1. Completed Application: Submit an application online.
2. Application fee of $100.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable): Documentation may include a copy of your marriage certificate or divorce decree.
6. Official Transcripts: Applicants must upload an official transcript obtained from the University. The transcripts from which you obtained your degree must show that all requirements for graduation have been met and the date the degree was conferred.
7. Certificate of Completion: Applicants must submit a completed Certificate of Completion completed and signed by the dean of applicant’s professional school and registrar of the university or college.
8. Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) Card: Applicants are required to submit a copy of your current BLS and/or ACLS certification card.
9. Examination Requirements:
   • National Board Examination: An official score report from the National Board Dental Examinations, sent directly to the Board from the National Boards, showing passing scores in all sections of the examination. Information on how to obtain your score report and fee information can be obtained by going to their website. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted.
   • Clinical Examination: An applicant must pass all parts of one (1) of the following examinations. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted. Please have your score report sent directly to the Board from one of the entities listed below:
     • Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org
     • Central Regional Dental Testing Service Examination (CRDTS)
       Website: www.crdts.org
     • Southern Regional Testing Agency (SRTA)Website: www.srta.org
10. Verification of State Licensure (if applicable): If you hold a license or certification in another State, you must provide verification of that information. Verifications must be completed from the state of issuance and can be uploaded to your online account.  Those jurisdictions may provide their own verification, or complete our verification form here. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure.
    
    The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
11. National Practitioner Data Bank (if applicable): Applicants who are now or have been licensed in another state or jurisdiction must submit a report from the National Practitioner Data Bank (NPDB). Please contact the NPDB to request a self-query report. All self-query report applications must be requested electronically through the NPDB website listed below. Information on how to complete a self-query is located on the website. Please review this helpful information on how to obtain your report. Once you receive your NPDB report, please forward the report to the Professional Licensing Agency.

National Practitioner Data Bank
P.O. Box 10832
Chantilly, Virginia 20153-0832
Website: www.npdb.hrsa.gov
Customer Service Center: 1-800-767-6732
Email: help@npdb.hrsa.gov

12. Jurisprudence Examination: Once all above items have been reviewed and approved, the applicant will be sent a jurisprudence exam by email. All applicants for dental licensure are required to pass a jurisprudence examination. No applicant is exempt from this requirement. You will have fourteen (14) days from the date the email is sent to you in order to complete the examination and return the required information to our office. All applicants will be examined on the Statute and Rules of Indiana related to the practice of dentistry and dental hygiene, universal precautions, and infectious wastes. This is a 30 question true-false and multiple-choice examination. Passing criteria is 75%. Statutes and Administrative Rules are available on the Resources page. The jurisprudence examination is based on the following:

Ind. Code 25-13 Dental Hygiene Law
Ind. Code 25-14 Dental Law
Ind. Code 25-1 Professional Licensing Agency General Provisions
Title 828 IAC Dental and Dental Hygiene Rules
Title 410 IAC 1-3 and 1-4 Infectious Waste and Universal Precaution

Application Checklist

For Applicants who currently hold an Active license in another State. Your license must be an equivalent dental hygiene license, and not show discipline against the license. If your license has been disciplined, your application will need to be reviewed by the Board prior to issuance. Use this section to ensure you've submitted all requirements.

1. Completed Application: Submit an application online.
2. Application fee of $100.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Criminal Background Check
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable):  Documentation may include a copy of your marriage certificate or divorce decree.
6. Verification of State Licensure: You must provide verification the license(s) or certification in another State. Verifications must be completed from the state of issuance and can be uploaded to your online account. Those jurisdictions may provide their own verification. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure. You must provide verification of all licenses that you have held.
   
   Your state may complete our verification form here. The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
7. Jurisprudence Examination: Once all above items have been reviewed and approved, the applicant will be sent a jurisprudence exam by email. All applicants for dental licensure are required to pass a jurisprudence examination. No applicant is exempt from this requirement. You will have fourteen (14) days from the date the email is sent to you in order to complete the examination and return the required information to our office. All applicants will be examined on the Statute and Rules of Indiana related to the practice of dentistry and dental hygiene, universal precautions, and infectious wastes. This is a 30 question true-false and multiple-choice examination. Passing criteria is 75%. Statutes and Administrative Rules are available on the Resources page. The jurisprudence examination is based on the following:

Ind. Code 25-13 Dental Hygiene Law
Ind. Code 25-14 Dental Law
Ind. Code 25-1 Professional Licensing Agency General Provisions
Title 828 IAC Dental and Dental Hygiene Rules
Title 410 IAC 1-3 and 1-4 Infectious Waste and Universal Precaution

Application Checklist

For Applicants who are employed by the Indiana University School of Dentistry (This license is only for Dentists). Use this section to ensure you've submitted all requirements.

1. Completed Application: Applications may be submitted online.
2. Application Fee of $250.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Letter from University: A letter from the Indiana University School of Dentistry verifying your employment and Education with their program.
4. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).
5. Name Change Documentation (if applicable):  Documentation may include a copy of your marriage certificate or divorce decree.
6. Official Transcripts: Applicants must upload an official transcript obtained from the University. The transcripts from which you obtained your degree must show that all requirements for graduation have been met and the date the degree was conferred.
7. Examination Requirements
   • National Board Examination: An official score report from the National Board Dental Examinations, sent directly to the Board from the National Boards, showing passing scores in all sections of the examination. Information on how to obtain your score report and fee information can be obtained by going to their website. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted.
   • Clinical Examination: An applicant must pass all parts of one (1) of the following examinations. Only official score reports can be accepted, copies of a student score report or certificate of passing will not be accepted. Please have your score report sent directly to the Board from one of the entities listed below:
     • Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org
     • Central Regional Dental Testing Service Examination (CRDTS)
       Website: www.crdts.org
     • Southern Regional Testing Agency (SRTA)Website: www.srta.org
8. Verification of State Licensure: If you hold a license or certification in another State, you must provide verification of that information. Verifications must be completed from the state of issuance and can be uploaded to your online account.  Those jurisdictions may provide their own verification, or complete our verification form here. Copies of license cards from other jurisdictions are not accepted as proof of verification of licensure.
   
   The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if you hold multiple licenses. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.
9. National Practitioner Data Bank: Applicants who are now or have been licensed to practice dentistry in another state or jurisdiction must submit a report from the National Practitioner Data Bank (NPDB). Please contact the NPDB to request a self-query report. All self-query report applications must be requested electronically through the NPDB website listed below. Information on how to complete a self-query is located on the website. Please review this helpful information on how to obtain your report. Once you receive your NPDB report, please forward the report to the Professional Licensing Agency. 
   National Practitioner Data Bank
   P.O. Box 10832
   Chantilly, Virginia 20153-0832
   Website: www.npdb.hrsa.gov
   Customer Service Center: 1-800-767-6732
   Email: help@npdb.hrsa.gov
10. Proof of Continuing Education: Applicants are required to submit proof of twenty (20) hours of continuing dental education taken in the previous two (2) years. No more than two (2) hours of training in basic life support shall count toward this requirement. Copies of certificates, letters from programs and/or transcripts are required.
11. English Proficiency Exam: The applicant must pass the Test of English as a Foreign Language (TOEFL) and submit proof of such to the Board.
    Note: According to IC 25-14-1-4.5(b), the Board, at its discretion, may waive the requirements of the English proficiency examination. If you are requesting a waiver, please provide a statement listing the details of your request.
12. Proof of Practice: The applicant must provide a statement listing where they have been employed (include dates of employment and practice address) for 5 years out of the 9 years.
13. Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) Card: Applicants are required to submit a copy of your current BLS and/or ACLS certification card.
14. Affidavit of Practice: Letter verifying that the Applicant will certify that they will teach and practice dentistry only at or on behalf of an Indiana school of Dentistry or an affiliated medical center of an Indiana School of Dentistry. The applicant shall further certify that the applicant will not engage in the private practice of dentistry.

Application Checklist

For Applicants who are employed by the Indiana University School of Dentistry (This license is only for Dentists). Use this section to ensure you've submitted all requirements.

1. Completed Application: Applications may be submitted online.
2. Letter from University: Please provide a letter from the school of Dentistry verifying their employment with the University including time of employment.
3. Positive Response Documentation (if applicable): If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).

Application Checklist

For Applicants who are enrolled in residency program by the Indiana University School of Dentistry (This license is only for Dentists). Use this section to ensure you've submitted all requirements.

1. Completed Application: Applications may be submitted online.
2. Letter from University: Please provide a letter from the school of Dentistry verifying your enrollment in the residency program. This letter should include the dates of the residency and name of your supervisor with their Indiana license credential information.

Application Checklist

For Applicants who licensed Dentists in the State of Indiana and wish to employ General Anesthesia, Deep Sedation, or Light Parenteral Conscious Sedation.

1. Completed Application: Applications may be submitted online.
2. Application Fee of $50.00: Fee is paid online during the online application process. All application fees are nonrefundable. Additional office address(s) must be submitted by paper notification to our office. Please see information below.
3. Proof of Sedation Training: An applicant must indicate which level of Sedation permit they wish to obtain on their application, and provide proof of training for one of the following :
   • General Anesthesia: An applicant for a permit to employ general anesthesia  must provide satisfactory evidence of completing a minimum of one (1) year of advanced (postdoctoral) training in anesthesiology and related academic subjects (postdoctoral) beyond the undergraduate dental school level in a residency in anesthesiology or oral surgery which meets the requirements stated in 828 IAC 3-1-3. Applicants must submit one of the following documents:
     • A copy of a certificate of completion of the educational or training program signed by the dean of the board approved dental school or director of the board approved anesthesiology residency from which the training was obtained.
     • An official transcript, sent directly from the school, from the board approved dental school which clearly designates completion of the education or training.
   • Deep Sedation: An applicant for a permit to employ general anesthesia  must provide satisfactory evidence of completing a minimum of one (1) year of advanced (postdoctoral) training in anesthesiology and related academic subjects (postdoctoral) beyond the undergraduate dental school level in a residency in anesthesiology or oral surgery which meets the requirements stated in 828 IAC 3-1-3. Applicants must submit one of the following documents:
     • A copy of a certificate of completion of the educational or training program signed by the dean of the board approved dental school or director of the board approved anesthesiology residency from which the training was obtained.
     • An official transcript, sent directly from the school, from the board approved dental school which clearly designates completion of the education or training.
   • Light Parenteral Conscious Sedation: An applicant who wishes to employ Light Parenteral Conscious Sedation must meet one (1) of the following educational and training criteria:
     • The applicant graduated from an approved dental school which included training in conscious sedation techniques at the predoctoral level. This training must meet the requirements of 828 IAC 3-1-5.
     • The applicant completed an intensive postdoctoral training program in the use of light parenteral conscious sedation which meets the requirements of 828 IAC 3-1-5.
     • Applicants must submit one of the following documents:
       • A copy of a certificate of completion of the educational or training program signed by the dean of the board approved dental school, medical school or director of a board approved hospital program from which the training was obtained.
       • An official transcript from a board approved dental school which clearly designates completion of the education or training.
       • A copy of a certificate of completion of a continuing education program which meets the requirements of 828 IAC 3-1-5. The certificate of completion shall be signed by the director of the continuing education program.
4. Advanced Cardiac Life Support (ACLS) Card: Applicants are required to submit a copy of your current ACLS certification card.

To Add Additional Offices and/or Hospitals

To add an additional office and/or hospital where you intend to administer general anesthesia, deep sedation, or light parenteral conscious sedation you will be required to submit the following:

1. Statement: A written request for an additional office and/or hospital with the dentist name, additional location, license and permit number.
2. Application Fee of $25.00: Make the check or money order payable to Indiana Professional Licensing Agency.  All application fees are nonrefundable.

Application Checklist

For Applicants who licensed Dental Hygienist in the State of Indiana and wish to employ local anesthetic.

Completed Application	Application Fee ($25)	Proof of Anesthetic Training
Local Anesthetic Examination

1. Completed Application: Applications may be submitted online. You must hold an current dental license in Indiana prior to submission
2. Application Fee of $25.00: Fee is paid online during the online application process.  All application fees are nonrefundable. Additional office address(s) must be submitted by paper notification to our office. Please see information below.
3. Proof of Anesthetic Training from School:
   • Applicants must submit an official document, directly from the school or program, showing proof of completion of Anesthetic training (must include University name and date earned). This must be a course in local anesthesia administration from an educational program accredited by the Commission on Dental Accreditation of the American Dental Association (CODA) that includes, at a minimum, fifteen (15) hours of didactic instruction and fourteen (14) hours of laboratory work covering the following subject areas:
     (1) Theory of pain control.
     (2) Selection of pain control modalities.
     (3) Anatomy.
     (4) Neurophysiology.
     (5) Pharmacology of local anesthesia.
     (6) Pharmacology of vasoconstrictors.
     (7) Psychological aspects of pain control.
     (8) Systemic complications.
     (9) Techniques of maxillary and mandibular anesthesia.
     (10) Infection control.
     (11) Local anesthesia medical emergencies.
     (12) A demonstration of clinical competency.
4. Clinical Examination Requirement: Applicants must submit verification of an official report showing the score attained on the local anesthesia examination. This exam must be local anesthesia focused (the clinical exam you completed for your dental hygiene program might not always apply). Please have your score report sent directly to the Board from one of the entities listed below:
   • Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org
   • REGIONAL OR STATE EXAMINATION: If you are licensed in another State and completed their own constructed exam for local anesthetic, please have that State provide a copy of the exam for the Board to review. 
     
     ****If you have not completed a local anesthesia examination administered by one of the entities listed above but have taken a substantially equivalent regional or state examination, please have the state or regional entity submit verification of the examination administered directly to the Board for review.

Application Checklist

Use this section to ensure you've submitted all requirements.

1. Completed Application: Applications may be submitted online.
2. Application fee of $60.00: Fee is paid online during the online application process.  All application fees are nonrefundable.
3. Continuing Education: Effective July 1, 2019, any licensed provider who applies for a controlled substance registration or renews a controlled substance registration must have two hours of continuing education in opioid abuse and prescribing to obtain or renew the registration. The two hours must be obtained within the previous two years prior to applying for or renewing a registration. Providers applying for a controlled substance registration who already hold a professional license will need to submit proof of the two hours of continuing education with their application.
4. For more information regarding Controlled Substance information, please visit the Indiana Board of Pharmacy here.

Application Checklist

For Applicants who have Dental Mobile Dental Facility or portable Dental Operation. Use this section to ensure you've submitted all requirements.

1. Application - Apply online.
2. Application fee of $200.00: To be paid by credit or debit card.  All application fees are nonrefundable.
3. Required Documentation: Please be prepared to upload the following documents:

• Proof of Communication Facility: Applicants must provide proof that they have a stationary location for record retention and communication of their mobile units.
• Proof of Radiographic Equipment Inspection: Applicants must show proof that they have radiographic equipment for their mobile units, and proof that they have met all safety regulations per the requirements set forth by the Department of Health.
• Emergency Care Procedure: Applicant must show an example of their emergency procedures of what actions they are taking to ensure patient care inside their mobile units.
• Letters of Support: Must provide copies of letters of support for the mobile Dental Facility.
• Valid Driver's License: Must show proof that the driver of the mobile unit holds a valid Driver's license in the State of Indiana.
• Copy of Consent Form: Must provide an example of the patient consent form they will complete when they use the mobile facility.
• Patient Information Sheet: Must show an example of the patient information sheet that the clients will complete when they use the mobile facility.

The Indiana Professional Licensing Agency does not issue licenses, permits, or certification for the practice of Dental Assisting. Please contact the Indiana Board of Health if you are a Dental Assistant who needs certification for your x-ray qualifications.

Continuing Education Requirements for Dentists

All Dentist licenses for the Indiana State Board of Dentistry expires on March 1of even-numbered years. Dentists are required to have completed twenty (20) hours of continuing education and are required to complete one-half of their continuing education in live presentations or live workshops. They are also required to complete a two (2) hour course which covers Ethics, Professional Responsibility and the Indiana Statutes and Administrative Rules per renewal period.  Renewal notices are sent approximately ninety (90) days prior to the expiration date. Please ensure you maintain current contact information from your online account. You may renew from your online account, or by submitting a paper renewal form with check or money order. Please review the fee schedule for the renewal fee requirements. Please see detailed information below.

Continuing education is not required by the dentist if they meet one of the following requirements:

1. A dentist who has held an initial license for less than two (2) years.
   (Example: Initial license was issued between the dates of March 2, 2022 to March 1, 2024)
2. A graduate student or a person in a residency program offered by an approved organization.
3. A person who is determined by the Board as being unable to practice dentistry due to a disability.

Inactive Status Change

A Dentist may request to be placed on "Inactive Status" at renewal by submitting a completed renewal form and marking "yes" for the question that asks if you would like to place your license in inactive status. There is no renewal fee or continuing education required to be placed on inactive status. If you wish to reactive your inactive license, please review the reinstatement requirements.

Dental Anesthesia Permits

Dentist - 828 IAC 3-1-7.5

In order to renew a permit to administer general anesthesia, deep sedation, or light parenteral conscious sedation, a dentist shall obtain five (5) hours of continuing education in every license period in the area of anesthesia. The continuing education may include, but its not limited to, a course in advanced cardiac resuscitation protocols. Courses in basic cardiac life support will not be accepted. The five (5) hours of continuing education required under this section counts toward the completion of continuing education requirements under IC 25-1-3.

If a dentist holds a General Anesthesia, Deep Sedation Permit or a Light Parenteral Conscious Sedation Permit they are required to complete five (5) hours of continuing education in the area anesthesia.

Continuing Education Requirements for Dental Hygienists

All Dental Hygienist licenses for the Indiana State Board of Dentistry expires on March 1of even-numbered years. Dental Hygienists are required to have completed nineteen (19) hours of continuing education and are required to complete one-half of their continuing education in live presentations or live workshops. They are also required to complete a basic life support course and a two (2) hour course which covers Ethics, Professional Responsibility and the Indiana Statutes and Administrative Rules per renewal period.  Renewal notices are sent approximately ninety (90) days prior to the expiration date. Please ensure you maintain current contact information from your online account. You may renew from your online account, or by submitting a paper renewal form with check or money order. Please review the fee schedule for the renewal fee requirements. Please see detailed information below.

Continuing education is not required by the dental hygienists if they meet one of the following requirements:

1. Example: Initial license was issued from March 2, 2022 to March 1, 2024.
2. A graduate student or a person in a residency program offered by an approved organization.
3. A person who is determined by the Board as being unable to practice dental hygiene due to a disability.

Inactive Status Change

A Dental Hygienist may request to be placed on "Inactive Status" at renewal by submitting a completed renewal form and marking "yes" for the question that asks if you would like to place your license in inactive status. There is no renewal fee or continuing education required to be placed on inactive status. If you wish to reactive your inactive license, please review the reinstatement requirements.

Display of License Requirement

• Dentist: The license shall be properly displayed at all times in the office of the person named as the holder of the license, and a person may not be considered to be in legal practice if the person does not possess the license and renewal card.
• Dental Hygienist:; The license to practice must be displayed at all times in plain view of the patients in the office where the holder is engaged in practice. No person may lawfully practice dental hygiene who does not possess a license and its current renewal.

Renewal Information
Renew your license online at mylicense.in.gov/eGov/ML1PLA.html. Renewal notices are sent approximately ninety (90) days prior to the expiration date.  Licensees with a valid email address on file will be emailed the renewal information.  Licensees that do not have a valid email address on file will be mailed license renewal information.  This notice is mailed to the licensee's address of record with the Board.

Reinstatement of an Expired License Information
If your license has been expired for three or more years, you must reinstate your license to practice. One renewal cycle is 20 hours of CE with 2 hours of Indiana ethics for Dentists, and 19 hours with 2 hours of Indiana ethics for Dental Hygienists. Please submit your reinstatement online with the additional documentation:

• Reinstate your license online at https://mylicense.in.gov/eGov/index.html (please note this is a different platform than the mentioned renewal link mentioned above.)
• Payment of the current renewal fee and current application fee.
• Documentation to Upload:
  • Copy of current CPR card. It will count for no more than (2) hours of your continuing education requirements.
  • Proof of continuing education since your license expired which must including 2 hours of Indiana ethics and jurisprudence (example: if you expired in 2016 you would show proof of CE from March 2014 to the present. This is to include the CE you should have been accruing during the time from your last active cycle to the present). Copies of certificates, letters from programs and/or transcripts are required. Please upload your CE into one pdf attachment! 
  • Statement of Practice. Please provide a brief statement in your own words on what you have been doing since your Indiana license has expired.

Upon receipt of the above items you may be scheduled to appear before the Board. The Board will determine if you will need to complete such remediation and/or additional training as deemed appropriate.

Reinstatement of an Inactive License Information
Inactive status as an Indiana Dentist or Dental Hygienist. One renewal cycle is 20 hours of CE with 2 hours of Indiana ethics for Dentists, and 19 hours with 2 hours of Indiana ethics for Dental Hygienists. Please review the fee schedule for the amounts needed to reinstate. All items must be submitted in one packet for review, if your packet is incomplete, it will be returned.

• Reinstate your license online at https://mylicense.in.gov/eGov/index.html (please note this is a different platform than the mentioned renewal link mentioned above.)
• Submit the Application Fee and the Late Fee ($50)
• Copy of current CPR card. It will count for no more than (2) hours of your continuing education requirements.
• Show proof of half the required continuing education needed since your license was inactivated. You must show completion of two (2) hours of Indiana ethics and jurisprudence.  (example: if you expired in 2016 you would show proof of CE from March 2014 to the present. This is to include the CE you should have been accruing during the time from your last active cycle to the present). Copies of certificates, letters from programs and/or transcripts are required. Please upload your CE into one pdf attachment!
• Statement of Practice. Please provide a statement in your own words on what you have been doing since your Indiana license has been inactive.

Upon receipt of the above items you may be scheduled to appear before the Board. The Board will determine if you will need to complete such remdiation and/or additional training as deemed appropriate.

Mobile Dental Facility Reinstatement
Reinstate your license online at https://mylicense.in.gov/eGov/index.html (please note this is a different platform than the mentioned renewal link mentioned above.) In order to do this, you must have your license number and Registration Code.  If you need your registration code, contact PLA at 317-232-2960 for the Call Center or email pla8@pla.in.gov.

APPROVED ORGANIZATIONS 
Approved organizations are also defined in three separate sections of the statute for Dentists and Dental Hygienists. One in the dental hygienists statutes (25-13-2-2); the dental statutes (25-14-3-2) and one in the Professional Licensing Agency statutes (25-1-4-0.2).

IC 25-13-2-2
"Approved organization" means the following:

1. United States Department of Education.
2. Council on Post-Secondary Education.
3. National Dental Association.
4. American Dental Association.
5. Academy of General Dentistry.
6. National Dental Hygiene Association.
7. American Dental Hygiene Association.
8. Council on Hospital Dental Services.
9. American Medical Association.
10. Joint Commission on Accreditation of Hospitals.
11. Joint Commission on Healthcare Organizations.
12. Study clubs approved by the board.
13. Federal, state, and local government agencies.
14. International organizations approved by the American Dental Association.
15. A college or other teaching institution accredited by the United States Department of Education or the Council on Post-Secondary Education.
16. A national, state, district, or local organization that operates as an affiliated entity under the approval of an organization listed in subdivisions (1) through (14).
17. An internship or a residency program conducted in a hospital that has been approved by an organization listed in subdivisions (1) through (15).
18. Any other organization or individual approved by the board.

IC 25-14-3-2
Approved organization means the following:

1. United States Department of Education.
2. Council on Post-Secondary Education.
3. National Dental Association.
4. American Dental Association.
5. Academy of General Dentistry.
6. National Dental Hygiene Association.
7. American Dental Hygiene Association.
8. Council on Hospital Dental Services.
9. American Medical Association.
10. Joint Commission on Accreditation of Hospitals.
11. Joint Commission on Healthcare Organizations.
12. Study clubs approved by the board.
13. Federal, state, and local government agencies.
14. International organizations approved by the American Dental Association.
15. A college or other teaching institution accredited by the United States Department of Education or the Council on Post-Secondary Education.
16. A national, state, district, or local organization that operates as an affiliated entity under the approval of any organization listed in subdivisions (1) through (14).
17. An internship or a residency program conducted in a hospital that has been approved by an organization listed in subdivisions (1) through (15).
18. Any other organization or individual approved by the board.

IC 25-1-4-0.2
"Approved organization" refers to the following:

1. United States Department of Education.
2. Council on Post-Secondary Education.
3. Joint Commission on Accreditation of Hospitals.
4. Joint Commission on Healthcare Organizations.
5. Federal, state, and local government agencies.
6. A college or other teaching institution accredited by the United States Department of Education or the Council on Post-Secondary Education.
7. A national organization of practitioners whose members practicing in Indiana are subject to regulation by a board or agency regulating a profession or occupation under this title or IC15.
8. A national, state, district, or local organization that operates as an affiliated entity under the approval of an organization listed in subdivisions (1) through (7).
9. An internship or a residency program conducted in a hospital that has been approved by an organization listed in subdivisions (1) through (7).
10. Any other organization or individual approved by the board.

It is the responsibility of the organization, If not specifically listed in the statute as an approved organization, or study club to request approval from the Board. An organization or study club will be able to tell licensees whether it has been approved by the Board. An approved organization or study club must provide participants with verification of course completion. Applications for approval of continuing education organization or study clubs are available at the Board’s website at http://www.in.gov/pla .

Courses given or sponsored by an approved organization regarding infectious diseases, universal precautions, and infection control will be accepted.

CONTINUING EDUCATION COURSE DEFINED

Continuing education is defined in three separate sections of the law. One in the dental hygienist statute (IC 25-13-2-3), the dental statute (IC 25-14-3-3) and one in the Professional Licensing Agency statute (IC 25-1-4-0.5).

IC 25-13-2-3
"Continuing education course" means an orderly process of instruction designed to directly enhance the practicing dental hygienist's knowledge and skill in providing relevant dental hygiene services that is approved by an approved organization.

IC 25-14-3-3
"Continuing education course" means an orderly process of instruction designed to directly enhance the practicing dentist's knowledge and skill in providing relevant dentist services that is approved by an approved organization

IC 25-1-4-0.5
"Continuing education" means an orderly process of instruction:

(1)  that is approved by:

(A)  an approved organization or the board for a profession or occupation other than a real estate appraiser; or

(2)  that is designed to directly enhance the practitioner's knowledge and skill in providing services relevant to the practitioner's profession or occupation.

*ETHICS, PROFESSIONAL RESPONSIBILITY, AND INDIANA STATUTE & ADMINISTRATIVE RULES CONTINUING EDUCATION REQUIREMENT FOR RENEWAL

828 IAC 1-5-6
(a) Effective for the license period ending March 1, 2006, for dentists and dental hygienists, and every license period thereafter, continuing education credit must include two (2) hours which shall cover each of the following subjects:

1. Ethics.
2. Professional responsibility.
3. Indiana statutes and Indiana administrative rules governing the licensure and practice of dentists and dental hygienists.

(b) Ethics and professional responsibility means the aspirational standards by which a profession decides to regulate its behavior in order to distinguish what is legitimate or acceptable in pursuit of their aims from what is not.
(c) The two (2) hours required under subsection (a) are not considered courses that relate specifically to the area of practice management.

Dentists and Dental Hygienists must complete a two (2) hour program which covers the following subject’s ethics, professional responsibility and the Indiana Statutes and Administrative Rules per renewal period. There is no exception to this rule.

BASIC LIFE SUPPORT FOR DENTAL HYGIENIST'S RENEWAL
IC 25-13-2-8(b)(3); IC 25-13-2-6(d); 828 IAC 1-6-1

"Basic Cardiac Life Support" means the successful completion of a course in artificial respiration and cardiac compression which enables the applicant to sustain life in an arrest state.

Dental Hygienists are required to complete a course in basic life support through a program approved by the Board for each renewal period.

Only two (2) hours for basic life support may be applied toward the credit hour requirement during each renewal period.

Waiver of BLS:  The Board may waive the basic life support requirement for licensees who show reasonable cause. A waiver of the requirement to complete a course in basic life support will only be granted for medical conditions or disabilities that prevent the dental hygienist from complying with the basic life support requirement. All requests for waivers of the basic life support requirement must be submitted in writing with the renewal application. A physician’s statement documenting the disability or medical condition must be submitted with the request.

Audits:  If the dental hygienist is audited for compliance with the requirement for completion of a basic life support course, at the time of the audit the dental hygienist must submit any of the following:

1. A copy of the cardiopulmonary resuscitation card showing the date of issuance and the date of expiration or date it is due for renewal.
2. A copy of the attendance sheet for the course that has been signed by the instructor and includes the date the course was given and certifies that the applicant successfully completed the course.
3. Proof of reasonable cause for noncompliance. A waiver will only be granted for medical conditions or disabilities that prevent the dental hygienist from complying with the basic life support requirement. All requests for waivers of the basic life support requirement must be submitted in writing. A physician’s statement documenting the disability or medical condition must be submitted with the request.

PRACTICE MANAGEMENT COURSES
Dentist - IC 25-14-3-8(c)
Dental Hygienists - IC 25-13-2-6(c)

A dentist or dental hygienists may not earn more than five (5) credit hours toward the requirements under this section for continuing education courses that relate specifically to the area of practice management.

DISTANCE LEARNING PROGRAMS
Dentist - IC 25-14-3-8(a)
Dental Hygienists - IC 25-13-2-6(e)

Online courses are acceptable to fulfill one-half the continuing education requirement for dentists and dental hygienists. The course must be approved by one of the accrediting bodies.

HARDSHIP WAIVER
IC 25-1-4-4

A board, a commission, a committee, or an agency regulating a profession or occupation under this title or under IC15, IC16, or IC22 may grant an applicant a waiver from all or part of the continuing education requirement for a renewal period if the applicant was not able to fulfill the requirement due to a hardship that resulted from any of the following:

• Service in the armed forces of the United States during a substantial part of the renewal period.
• An incapacitating illness or injury.
• Other circumstances determined by the board or agency.If a licensee is unable to complete continuing education under the statute listed above, please submit your completed renewal and renewal fee along with written explanation and any other documentation regarding your disability, incapacitating illness or injury, etc. If it is based upon your service in the armed forces please submit copies of your service papers.

RETENTION OF CONTINUING EDUCATION CERTIFICATES
IC 25-1-4-3(a)(2)

Practitioners must retain copies of certificates of completion for CE courses for three (3) years from the end of licensing period for which the continuing education applied.

A licensee is not required to submit copies of their continuing education certificates at the time of renewal. By renewing online or signing the renewal application you swear or affirm under the penalties of perjury that you have completed the continuing education requirement. A practitioner shall retain copies of continuing education certificates for three (3) years from the end of the licensing period.

RANDOM CONTINUING EDUCATION AUDITS
IC 25-1-4-3(b)

Following every license renewal period, the Board shall randomly audit for compliance more than one percent (1%) but less than ten percent (10%) of the practitioners required to take continuing education courses.

After the renewal, a percentage of licensees will be chosen in a random audit to submit copies of their continuing education certificates. If the licensee does not comply with the audit the Board will proceed with action as specified IC 25-1-4-5, IC 25-1-4-6, 28 IAC 1-5-4 and 828 IAC 1-5-5.

AWARD OF CONTINUING EDUCATION CREDIT
Dentist - IC 25-14-3-9
Dental Hygienists - IC 25-13-2-7

COLLEGE COURSE
A course presented by a college under a regular curriculum is awarded one (1) credit hour for each lecture hour attended.

OTHER COURSES NOT COLLEGE COURSES
If the course does not fall under a college course it is awarded one (1) credit hour for each lecture hour and two (2) credit hours for each participation hour of the course.

SPEECH, LECTURE, OR OTHER PRESENTATION BY A DENTIST
A speech, lecture, or other presentation by a dentist is awarded two (2) credit hours if the following conditions are met:

• The presentation concerns a subject that would be suitable for a continuing education course.
• The subject of the presentation is eligible for credit only once regardless of the number of times it is presented.
• The dentist maintains a record of the time, place, and date of the presentation.
• The presentation is sponsored by an approved organization.
• Not more than four (4) credit hours are awarded to the dentist under this subdivision during a license period.

STUDY CLUB
Attendance at a meeting of a study club that uses films, audio cassettes, live presentations or written materials sponsored by the American Dental Association is awarded one (1) credit hour. However, a dentist may not receive credit under this subdivision for more than four (4) credit hours during a license period.

Attendance at a meeting of a study club featuring a guest speaker whose presentation concerns a subject suitable for a continuing course is awarded one (1) credit hour for each hour attended.

HOME STUDY
A home study course that is presented by an approved organization and meets the requirements under this subdivision is awarded the same number of credit hours given to courses provided by a college. If the approved organization does not assess credit hours to a course under this subdivision, the course is awarded one (1) credit hour for each hour of study material. Subject matter of the course may be presented by written, audio, or video materials.

Approval of an Individual or Organization to Provide Continuing Education Courses for Dentists and Dental Hygienists

This checklist is for applicants who are applying to become a Continuing Education Sponsor in the State of Indiana.

1. Application - Apply online
2. Required Documentation: Please be prepared to upload the following with your application
   • Mission Statement: Applicants must provide a brief statement of their goals of the type of CE they will be presenting for the profession.
   • List of Anticipated Programs: Applicants must submit a list of each program that will be presented, or a copy of the programs that have been held by the sponsor for the last two (2) years with the date and location of the program, brief content summary, name and academic and professional background of the lecturer, and number of clock hours granted by that program.
   • Presenter Information: Application must provide a list of names and credentials of all presenters. Please submit a copy of their Curriculum Vitae.
   • Programs Offered: Applicants must provide a list or brochure of the courses that will be offered as a CE Provider. This must include the names of the courses and where they will be held. If they are being held virtual, it must be indicated and if the course will have an exam at the end of the course.
   • Sample Course: Please provide a copy sample of one of the courses that will be presented, or that you have presented previously.
   • Sample Course Evaluation: Please provide a copy of the evaluation form you will be providing to professionals taking your course.
   • Sample Sign-in Sheet: Please provide a sample of the sign in sheet you will be using to keep track of the professionals attending your course(s). Your sheet at minimum should contain the following:
     • Name of the Program
     • Name of Presenter(s)
     • Date
     • Location
   • Sample Certificate of Completion: Please provide a copy of your certificate of completion you will provide the professionals who have completed your course(s). Your certificate should contain at minimum the number of hours awarded, completion date, and group(s) approving Presentation.

Approval of a Study Club to Provide Continuing Education Courses for Dentists and Dental Hygienists

This checklist is for applicants who are applying to become a Study Club in the State of Indiana. Programs presented prior to the receipt of approval or after the withdrawal or termination of approval by the board shall not count toward continuing education requirements. A Study Club is a nonrenewable sponsor. Approval must be granted each license period if it is an ongoing study club.

1. Application - Apply online.
2. Required Documentation: Please be prepared to upload the following with your application
   • Mission Statement: Applicants must provide a brief statement of their goals of the type of CE they will be presenting for the profession.
   • Sample Certificate of Completion: Please provide a copy of your certificate of completion you will provide the professionals who have completed your course(s). Your certificate should contain at minimum the number of hours awarded, completion date, and group(s) approving Presentation.
   • Sample Sign-in Sheet: Please provide a sample of the sign in sheet you will be using to keep track of the professionals attending your course(s). Your sheet at minimum should contain the following:
     • Name of the Program
     • Name of Presenter(s)
     • Date
     • Location
   • Study Club Bylaws: Please submit a copy of the study group's bylaws.

• National Board Examination: Applicants must submit an official score report from the National Board Dental Examiners, sent directly to the Board from the National Boards, showing passing scores in all sections of the examination. Information on how to obtain your score report and fee information can be obtained by going to their website.

• Commission on Dental Competency Assessment (CDCA), North East Regional Board (NERB), Western Regional Examining Board (WREB), and Council of Interstate Testing Agency (CITA) Website: cdcaexams.org

• Central Regional Dental Testing Service Examination (CRDTS)
  Website: www.crdts.org

• Southern Regional Testing Agency (SRTA)Website: www.srta.org

Penalties for Non-Compliance with Continuing Education Requirements: If a dentist is not in compliance with the continuing education requirements, pursuant to Ind. Code 25-1-4-5(b)(2)(A) the board may impose a civil penalty, not to exceed one thousand dollars ($1,000.00). If the board determines that a practitioner has knowingly or intentionally made a false or misleading statement to the board concerning compliance with the continuing education audit requirements, the board may impose a civil penalty of not more than five thousand dollars ($5,000.00) under Ind. Code 25-1-4-5(b)(2)(A).

Penalties for Non-Compliance With Continuing Education Requirements: If a dental hygienist is not in compliance with the continuing education requirements, pursuant to Ind. Code 25-1-4-5(b)(2)(A) the board may impose a civil penalty, not to exceed one thousand dollars ($1,000.00). If the board determines that a practitioner has knowingly or intentionally made a false or misleading statement to the board concerning compliance with the continuing education audit requirements, the board may impose a civil penalty of not more than five thousand dollars ($5,000.00) under Ind. Code 25-1-4-5(b)(2)(A).