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Licensee Forms

  • Notification of Name Change Form
  • Notification of Address Change Form
  • Reactivation Application for Inactive/Retired License Form
  • Voluntary Surrender
  • Infection Control Initial Inspection Request Form
  • Infection Control Inspection/Survey Form
  • Local Anesthesia Permit Application (Hygiene Only)
  • Nitrous Oxide Permit Application (Hygiene Only)
  • Public Health Endorsement Application Form (Hygiene Only)
  • Request for Advisory Opinion Form
  • Exam / License Verification Order Form
  • Purchase Order & Credit Card Payment Form
  • General Anesthesia / Deep Sedation Inspection and Evaluation Form
  • Moderate Sedation Inspection and Evaluation Form
  • Prescription Monitoring Program Annual Self Query
Home
State of NevadaNevada Governor
Consumers
License VerificationFile A ComplaintHelpful Links for ConsumersHealth Care Records Statutes and Regulations
Licensure
Apply for a LicenseDental AssistantsLicensee Resources
Business Services
Public Info
Public MeetingsAdvisory OpinionsLegislative Session in ReviewEvent Calendar
About
Mission StatementBoard MembersStaff
Contact
StaffState HolidaysPetition the Board
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