(a) The board will
issue a license by credentials to practice dental hygiene under this section to
an applicant who meets the requirements of
AS
08.32.014,
08.32.030 and this
section.
(b) An applicant for
license under this section shall submit to the department
(1) a complete, notarized application on a
form provided by the department;
(2) the applicable fees established in
12 AAC 02.190;
(3) an authorization from the applicant for
release of the applicant's records to the department;
(4) an affidavit from the applicant that
lists the license number and the name of the jurisdiction for all dental
hygiene licenses that the applicant holds or has ever held in any
jurisdiction;
(6) a copy of a current
certification in cardiopulmonary resuscitation (CPR) techniques for the
applicant that meets the requirements of
12 AAC 28.920;
(7) a copy of the applicant's certificate of
examination that meets the requirements of
AS
08.32.014(a)(1)(B);
(8) a copy of the applicant's certificate of
examination that meets the requirements of
AS
08.32.014(a)(1)(C);
(9) as required under
12 AAC 28.908(a),
a statement from the applicant certifying the applicant will adhere to the
ethical standards specified in
12 AAC
28.905(a);
(10) an affidavit from the applicant stating
the applicant is not impaired to an extent that affects the applicant's ability
to practice dental hygiene; and
(11) an affidavit from the applicant
documenting
(A) the dates and locations where
the applicant has practiced dental hygiene during the five years immediately
preceeding the date of application;
(c) In addition to the
requirements of (a) and (b) of this section, an applicant for a license under
this section shall arrange for and ensure the submission of
(1) if the applicant is or has ever been
employed as a dental hygienist with a federal agency, verification of the
current status and disciplinary history from each federal agency where the
applicant is or has been employed, sent directly to the department from the
agency;
(2) verification of the
applicant's status and complete information regarding any disciplinary action
or investigation taken or pending from all licensing jurisdictions where the
applicant holds or has ever held a dental hygiene license, sent directly to the
department from the licensing jurisdiction;
(4) an official transcript sent directly to
the department from the educational institution verifying graduation from a
dental hygiene program that meets the requirements of
AS
08.32.014(a)(1)(A).
(d) In addition to the
requirements of this section, an applicant for a dental hygiene license must
document completion of the jurisprudence examination prepared by the board,
covering the provisions of AS 08.32, AS 08.36 and this chapter relating to the
practice of dental hygiene, with a passing score of at least 70 percent
hygienist.
