(a) The board will
issue a license by credentials to practice dentistry to an applicant who meets
the requirements of
AS
08.36.110,
08.36.234 and this
section.
(b) An applicant for a
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 name of the jurisdiction for all dental licenses
that the applicant holds or has ever held in any jurisdiction;
(5) verification of the status of the
applicant's registration with the Drug Enforcement Administration (DEA), sent
directly to the department from DEA, even if the applicant is not currently
registered with the DEA;
(7) if the
applicant holds a valid federal Drug Enforcement Administration registration
number, verification that the applicant has completed not less than two hours
of education in pain management and opioid use and addiction within the two
years before the date of application;
(8) a copy of a current certification in
cardiopulmonary resuscitation (CPR) techniques that meets the requirements of
12 AAC 28.920;
(9) a copy of the applicant's certificate
from the American Dental Association Joint Commission on National Dental
Examinations verifying successful passage of the National Board Dental
Examination Part I and Part II, or the Integrated National Board Dental
Examination;
(10) an affidavit from
the applicant stating the applicant is not impaired to an extent that affects
the applicant's ability to practice dentistry;
(11) as required under
12 AAC 28.908(b),
a statement from the applicant certifying the applicant will adhere to the
ethical standards specified in
12 AAC 28.905(b);
and
(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 submission of
(1) if the applicant is or has ever been
employed as a dentist 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;
(3) 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 license, sent directly to the department from the
licensing jurisdiction;
(6) an official
transcript sent directly to the department from a dental school verifying a
dental degree from a school that meets the requirements of
12 AAC 28.938.
(d) In addition to the requirements of this
section, an applicant for! dental 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 dentistry, with a
passing score of at least 70 percent.
(g) The personal interview of the applicant
required in
AS
08.36.234(d) must be
completed.
