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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
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Home
State of Nevada
Nevada Governor
Consumers
Frequently Asked Questions
License Verification
File A Complaint
Governing Laws
Helpful Links for Consumers
Health Care Records Statutes and Regulations
Licensure
Apply for a License
Dental Assistants
Licensee Resources
Change of Address
Infection Control
Governing Laws
Business Services
Public Info
Public Meetings
Newsletters & Press Releases
Public Safety
Advisory Opinions
Legislative Session in Review
Event Calendar
Technical Bulletins
About
Mission
Board Members
Staff
Contact
Contact Us
Staff
State Holidays
Petition the Board
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