How to Fill Out the North Carolina Board of Dental Examiners License Application + FAQs

The North Carolina dental license application is the form every person must file with the North Carolina State Board of Dental Examiners before they can legally practice dentistry or dental hygiene in the state. It collects your identity, your education, your exam scores, your work history, and your character record so the Board can decide if you are fit to hold a license under N.C. Gen. Stat. § 90-30.

This form is not a quick sign-up sheet. One wrong box, one missing seal, or one skipped question can stall your file for months, and the rules in 21 NCAC 16B .0301 are strict about what counts as a complete package. The Board warns that the review can take up to 90 days, and that any application not finished within one year is thrown out with no refund of your fee.

Here is what you will learn in this guide:

• 📋 What the application is, who must file it, and which version applies to you
• 🗂️ The exact documents, seals, and ID numbers to gather before you open the form
• ✍️ A line-by-line walkthrough of every box, with sample entries you can copy
• 👥 Three full filled-out examples for a new graduate, an out-of-state dentist, and a foreign-trained dentist
• ⚠️ The field mistakes that get files rejected, plus how to file and what happens next

What the Form Is and Who Must File It

The North Carolina dental license application is the official, notarized form the Board uses to grant a license to practice dentistry or dental hygiene. The form exists because state law bars anyone from practicing without a license, and 21 NCAC 16B .0101 requires every applicant to pass Board-approved written and clinical exams before a license is issued. The Board receives the form, the statute N.C. Gen. Stat. § 90-30 requires it, the one-year completion window governs it, and loss of your fee is the penalty for an incomplete or false file.

You must file this form if you want to practice dentistry or dental hygiene in North Carolina and you do not already hold an active license. There are several routes, and each one uses its own version of the form, so picking the right route is your first real decision.

• Licensure by Examination is for new dental or dental hygiene graduates who have just passed their national and clinical exams.
• Licensure by Credentials is for dentists already licensed and practicing in another U.S. state who want to move to North Carolina without retaking the full clinical exam, under N.C. Gen. Stat. § 90-36.
• Provisional, Intern, and Instructor licenses cover dentists working in teaching hospitals, residencies, or dental schools.
• Anesthesia and Sedation permits are add-on permits, not stand-alone licenses.

It helps to know how the key players relate. The Board is the agency that grants the license. The statute, Chapter 90 Article 2, is the law that creates the Board and the duty to be licensed. The rules in Title 21, Chapter 16 are the detailed steps the Board writes to carry out that law. The Commission on Dental Accreditation (CODA) accredits the schools you must graduate from, and the ADEX clinical exam supplies the scores the Board demands. Each link in this chain feeds the next, and a gap in any one of them stops your license.

Before You Start: Documents and Information You Need

Gather everything below before you open the form, because the Board will not accept a partial package and will return it with a $10.00 processing fee if it is incomplete. The application is a “complete package” requirement, meaning all parts must arrive together, not in pieces over time.

• Government photo ID and Social Security number. The Board cross-checks your identity, and a missing or wrong SSN stalls the criminal background check.
• A passport-size photograph taken within the last six months. It must be glued, not stapled, to the form; a missing photo makes the file incomplete.
• Official dental school transcripts in a sealed envelope. Per 21 NCAC 16B .0301(c), the school must seal the envelope, and an opened envelope is rejected.
• National exam scores (NBDE Parts I and II or the INBDE). You must authorize the Board to access them, or the file cannot be scored.
• Clinical exam scores (ADEX or another Board-accepted exam). The Board needs proof you passed a hands-on exam.
• Your 10-year address history and 10-year non-dental job history. Gaps trigger follow-up letters that slow the review.
• Fingerprint Record Card and a signed release form. Out-of-state residents mail a card; in-state residents may use LiveScan.
• A current, unexpired CPR certificate. An expired card makes the application incomplete.
• Certificate of licensure status from every state where you hold or held a license. Required for the credentials route under G.S. 90-36.
• A National Practitioner Data Bank (NPDB) report obtained within the last six months. Required if you hold or held a license elsewhere.
• Your non-refundable fee. The Board accepts a certified check, personal check, or money order, but never cash.

Write your answers on a scratch copy first. Many boxes ask for dates, license numbers, and reasons for leaving past jobs that you may not remember off the top of your head, and guessing on a notarized form is a serious risk.

Where to Get the Form and How to Access It

You get the official application from the Board’s own license page, which links to separate packages for Dental, Dental Hygiene, Intern Permit, Anesthesia and Sedation, and Predetermination. The rule 21 NCAC 16B .0301(a) states that all applications must be made on the forms furnished by the Board, so a copied or outdated form is not valid.

You can reach the form three ways. You can download and print the PDF package from the website. You can request a paper copy by email at info@ncdentalboard.org or through the Board’s electronic forms link. You can also pick one up in person at the Executive Office at 2000 Perimeter Park Drive, Suite 160, Morrisville, NC 27560.

The Board also offers two required written exams online: one on infection control and sterilization, and one on North Carolina jurisprudence. These are separate from the paper application but must be passed for licensure by exam, credentials, or provisional license, so check the dental information page for the online testing link.

One detail people miss: the form prints a revision marker, such as “Rev 07,” near the title. Confirm you are using the current revision before you fill anything in, because the Board updates question wording, and an old version may omit a required field like the employee-misclassification notice added under N.C. Gen. Stat. § 143-764. If you are unsure which version is current, call the Board at (919) 678-8223 before mailing.

Step-by-Step: How to Fill Out the NC Dental License Application Line by Line

Work through the form in order, in black ink or typed, and answer every question fully and truthfully. The form says DO NOT SEPARATE THIS FORM AND DO NOT STAPLE ENCLOSURES, so keep pages together and use paper clips or riders for extra sheets.

The Photo Box (Top of Form)

This box at the top asks for a recent photo of your face. You glue a passport-size photograph, no smaller than 2×2 inches and no larger than the printed space, taken within the last six months. Dr. Lena Park glues a printed 2×2 studio headshot into the box and trims the white border so it fits. If your only photo is larger, have a print shop resize it rather than folding it to fit. The most common mistake is using a Polaroid or a stapled snapshot, which the Board flatly rejects and treats as a missing item, stalling the whole package. Many people think a casual phone selfie printed at home is fine, but the Board expects a clear, passport-style image, so a blurry or dark print can get bounced.

Question 1 — Full Name

This box asks for your complete legal name. You write your first name in full, then your middle or maiden name, then your last name in full, exactly as they appear on your dental school diploma and Social Security card. Maria Elena Gonzalez writes “Maria” / “Elena” / “Gonzalez” across the three name fields. If you go by a nickname or shortened name on documents, still use your full legal name here. The common mistake is entering a professional or nickname that does not match your transcript, which causes a name-mismatch hold while the Board confirms you are the same person. People wrongly believe they can use the name on their work badge, but the Board matches this field against your sealed school records.

Question 1 (continued) — Present and Permanent Address

These lines ask where you live now and your permanent home address. You print the street address, city, state, ZIP, and county for both, and you may repeat the same address if they match. James Carter lists his present address as “412 Oak St, Cary, NC 27513, Wake” and writes the same line for permanent. If you are mid-move, list the address where you can receive certified mail, since the Board sends notices there. Forgetting the county is a frequent slip, and a blank county field can delay the SBI background check that is tied to your address. Some applicants think a P.O. Box alone is enough, but the Board wants a physical street address for residency, so list the street and add the P.O. Box only as a mailing line.

Question 2 — Preferred Mailing Address

This box asks which address the Board should use for all mail. You check either Present or Permanent so the Board knows where to send letters and your license. Lena Park checks “Present” because she just signed a lease near her new office. If you expect to move within 90 days, pick the address that will be stable through the review. The mistake here is checking neither box, which leaves the Board guessing and risks a notice going to an old address. Many filers assume the Board will just use the first address listed, but the form requires a clear choice, so an unmarked box is treated as incomplete.

Question 3 — Telephone and Email

This box asks for a daytime phone number and an email address. You enter a number where staff can reach you during business hours and an email you check often, because the Board uses both for fast follow-up. James Carter writes “(919) 555-0148” and “jcarter.dds@email.com.” Use a personal email, not a school address that will expire after graduation. The common error is listing a school email that shuts off weeks later, so the Board’s questions bounce and your file sits. People think email is optional, but 21 NCAC 16B .0301(a)(6) lists email as required information.

Question 4 — Age, Date of Birth, Place of Birth

This box asks your age, date of birth, and place of birth. You write your age in years, your birth date as MM/DD/YYYY, and the city, state, and country where you were born. Maria Gonzalez writes “34,” “06/22/1991,” and “Houston, Texas, USA.” If you were born abroad, list the city and country exactly as on your passport. The mistake people make is writing the date in a non-standard format that does not match their ID, which can flag a data-entry review. Some assume place of birth is just the state, but the Board wants the city too, so a one-word answer may draw a follow-up.

Question 5 — Social Security Number

This box asks for your nine-digit Social Security number. You print it in the three grouped spaces, and you double-check each digit because the Board runs your background and identity checks against it. James Carter enters “228-19-3047.” If you are a foreign-trained applicant without an SSN yet, contact the Board for guidance before submitting rather than leaving it blank. A transposed digit is the classic error here, and it can attach someone else’s record to your file or stall the SBI check entirely. People think the SSN is optional for privacy reasons, but 21 NCAC 16B .0301(a)(11) makes it required.

Question 6 — Other Names Used

This box asks whether you have ever been known by another name. You check Yes or No, and if Yes, you list every former name, including a maiden name, and attach a certified court order if a court changed your name. Maria Gonzalez checks “Yes” and lists “Maria Elena Ramirez” with a certified copy of her marriage-based name-change order. If your diploma shows a maiden name but your license will be in your married name, this box is how you connect them. The mistake is checking No when your transcript and ID names differ, which looks like you hid something and can trigger a fraud review. People wrongly think only legal court changes count, but a maiden name belongs here too.

Question 7 — U.S. Citizenship

This box asks if you are a U.S. citizen. You check Yes or No, and if No, you attach proof of your immigration status and your right to work and hold a professional license. Dr. Aarav Mehta, trained in India, checks “No” and attaches a copy of his green card. If your status is pending, include the most current USCIS document you have. The mistake is checking No without attaching documents, which makes the file incomplete under 21 NCAC 16B .0301(a)(10). Some assume citizenship is required to be licensed, but lawful work authorization is what the Board checks, not citizenship itself.

Question 8 — Marital Status

This box asks your marital status. You check one option: Single, Married, or Divorced. Lena Park checks “Married.” If you are separated but not divorced, the Board generally expects Married unless a decree is final. The mistake is leaving it blank, which keeps the file from being marked complete. People think this question is intrusive or optional, but it is required information under the rule, so you must answer it.

Question 9 — 10-Year Address History

This box asks for every place you have lived in the past 10 years. You list each city, state, and the dates you lived there, attaching a separate signed sheet if you run out of room. James Carter lists “Chapel Hill, NC, 2018–2024” and “Cary, NC, 2024–present.” Account for every month, because gaps make the SBI background check harder and slower. The mistake is leaving date gaps between addresses, which prompts the Board to write back for the missing periods. Some applicants list only their current state, but the Board wants the full decade across all states.

Question 10 — Two People Who Know Your Address

This box asks for two people who will always know how to reach you. You write the name, full address, and phone number for each, choosing people who are stable and easy to find, like a parent or close friend. Maria Gonzalez lists her mother and her former dental school roommate with current phone numbers. Avoid listing two people who live with you, since the point is to reach you if you move. The mistake is naming someone with outdated contact details, which weakens the Board’s ability to verify you. People think any two names will do, but the Board may actually contact them, so pick reachable people.

Question 11 — Bankruptcy

This box asks whether you have ever filed for bankruptcy. You check Yes or No, and if Yes, you explain on the line or an attached sheet. Dr. Aarav Mehta checks “No.” If you filed years ago and it was discharged, still check Yes and give the year and chapter. The mistake is hiding an old filing, since the Board can find it and an omission looks worse than the bankruptcy itself. People think bankruptcy bars a license, but it does not on its own; failing to disclose it is the real danger.

Question 12 — Driver’s Licenses

This box asks for your current and past driver’s licenses. You list the license number, the issuing state, and the dates you held each one. James Carter writes “NC, 0048213, 2016–present.” If you held licenses in more than one state, list them all, even expired ones. The mistake is listing only your current license when you held one in another state, which creates a gap the Board may question during the background check. Some think only the current license matters, but 21 NCAC 16B .0301(a)(17) asks for past states too.

Question 13 — Non-Dental Jobs (Past 10 Years)

This box asks for every non-dentistry job you held in the past 10 years. You list the occupation, the employer with address and phone, the dates, and the reason you left if you were terminated or asked to leave. Lena Park lists “Barista, The Daily Grind, 2014–2016, left to attend dental school.” Include part-time and summer work to avoid timeline gaps. The mistake is skipping short jobs, which leaves holes the Board reads as missing information. People assume only career jobs count, but the question covers all employment outside dentistry.

Questions 14–15 — Military Service and Criminal History

These boxes ask about military service and any criminal history. For Question 14 you check whether you served, and explain any separation, charges, or court-martial; for Question 15 you answer seven Yes/No prompts covering being summoned, arrested, taken into custody, indicted, convicted, charged, or pleading guilty to any law violation. James Carter checks “No” to military service and “No” to all seven criminal prompts. You may exclude only minor traffic tickets unrelated to alcohol or drugs. The mistake is hiding a dismissed or expunged charge, since the SBI check may still surface it and non-disclosure is itself grounds for denial. People think a charge that did not lead to conviction need not be listed, but the questions ask about arrests and charges, not just convictions.

Questions 16–17 — Fitness and Health Conditions

These boxes ask about recent conduct and any current condition that affects your ability to practice. For Question 16 you disclose any conduct in the past five years that could question your fitness; for Question 17 you state whether you have a current impairment, including substance or alcohol abuse or a mental health condition, and whether treatment reduces it. Dr. Aarav Mehta checks “No” to both, having no such conditions. If you answer Yes, you complete a separate release and summary form for each provider. The mistake is reading “currently” too broadly and over-disclosing a long-resolved issue, or too narrowly and hiding an active one. People fear any Yes ends their chances, but the Board focuses on whether you can practice safely, often with monitoring.

Questions 18–20 — Education and School Discipline

These boxes ask about post-graduate training and any school discipline. Question 18 asks if you took training beyond continuing education; Questions 19 and 20 ask if you were ever dropped, suspended, expelled, or denied admission for cause. Maria Gonzalez checks “Yes” to Question 18 and lists a one-year general practice residency, and “No” to 19 and 20. List residencies and fellowships, but not routine CE courses. The mistake is failing to mention a residency that your transcript references, creating a mismatch. People think only negative items matter here, but Question 18 wants your extra training listed too.

Pre-Dental and Dental Education Blocks

These blocks ask where you went to college and dental school. You write the name and location of each school, the period of attendance, the degree earned, the granting institution, and the exact graduation date. James Carter lists “UNC-Chapel Hill, 2012–2016, B.S.” and “UNC Adams School of Dentistry, 2016–2020, DDS, conferred May 2020.” Your dental school must be CODA-accredited. The mistake is listing a graduation date that does not match your sealed transcript, which forces the Board to reconcile the two. People think rounding the year is fine, but the Board matches the exact conferral date on your transcript.

Question 21 — Dental Licenses in Other Jurisdictions

This box asks where you are or were licensed to practice dentistry. You list each jurisdiction, how you were licensed (exam or reciprocity), the license number, the issue date, and your years of practice. Dr. Aarav Mehta lists “Virginia, Exam, VA-DDS-44120, issued 2019, 6 years.” This box is central for the credentials route under G.S. 90-36. The mistake is leaving out a lapsed or inactive license, which the NPDB report will reveal and which then looks concealed. People think only active licenses count, but the Board wants every license you have ever held.

Questions 22–28 — Discipline, Data Bank, and Other Licenses

These boxes ask about professional discipline and other health licenses. They cover dental society membership, any suspension or reprimand, complaints or proceedings, National Practitioner Data Bank reports, specialty status, other health care licenses, hospital privilege loss, and DEA registration history. James Carter checks “No” to all discipline and data-bank questions and “No” to holding a DEA number as a new graduate. For any Yes, you attach a full written statement with dates, the nature of the matter, the disposition, and the record-holder’s address. The mistake is a one-line answer where the form demands a detailed statement, which the Board treats as incomplete. People think a Yes to discipline ends the application, but full honest disclosure is what the Board weighs, and hiding it is far worse.

Question 29 and the Signature, Notary, and Public Notice

This final section is your sworn declaration and signatures. You read the honor pledge and the broad release authorizing the Board to gather records, then sign and print your name; next you swear before a Notary Public that all answers are true, and the notary completes the certificate, date, and seal. Maria Gonzalez signs both signature lines, then signs again in front of a notary who stamps the seal. You also answer the employee-misclassification Public Notice required by N.C. Gen. Stat. § 143-764. The biggest mistake is signing the notary block before reaching the notary, since the notary must witness your signature, and a pre-signed form is invalid. People think any signature works, but an un-notarized application is automatically rejected under 21 NCAC 16B .0301(b).

Three Filled-Out Examples Using Real Scenarios

Below are three common filers walked through the form. Each shows what that person enters in the key sections so you can compare your own situation.

Scenario 1: Maria Gonzalez, a new DDS graduate applying by Examination

Form Section	What Maria Enters
Question 1 (Name)	Maria / Elena / Gonzalez
Question 5 (SSN)	228-44-1190
Question 6 (Other names)	Yes — formerly Maria Elena Ramirez, court order attached
Question 7 (Citizenship)	Yes
Dental Education	UNC Adams School of Dentistry, 2020–2024, DDS conferred May 2024
Question 18 (Post-grad training)	Yes — one-year GPR residency
Question 21 (Other licenses)	None — first license
Exam scores submitted	INBDE plus ADEX clinical, sent sealed
Fee	Examination fee, personal check
Notary block	Signed before notary, sealed

Scenario 2: James Carter, an out-of-state dentist applying by Credentials

Form Section	What James Enters
Question 1 (Name)	James / Robert / Carter
Question 9 (10-year address)	Richmond, VA 2015–2024; Cary, NC 2024–present
Question 13 (Non-dental jobs)	None in past 10 years
Question 21 (Other licenses)	Virginia, Exam, VA-DDS-39812, issued 2016, 8 years
Certificate of licensure status	Requested from Virginia Board, sent sealed
NPDB report	Obtained within last six months, attached
Question 28 (DEA)	Yes, active, never disciplined
Letter of recommendation	From current employer, attached
Fee	Credentials fee $2,000, certified check
Notary block	Signed before notary, sealed

Scenario 3: Dr. Aarav Mehta, a foreign-trained dentist now U.S.-licensed

Form Section	What Aarav Enters
Question 1 (Name)	Aarav / (none) / Mehta
Question 7 (Citizenship)	No — green card copy attached
Pre-Dental Education	University of Mumbai, 2008–2012, B.D.S.
Dental Education	NYU CODA-accredited DDS completion program, 2017–2019
Question 21 (Other licenses)	New Jersey, Exam, NJ-44021, issued 2019, 6 years
Question 16 (Conduct)	No
NPDB report	Obtained within six months, attached
Transcripts	Sealed CODA-program transcript sent by NYU
Fee	Credentials fee, money order
Notary block	Signed before notary, sealed

How to File the Completed Form

The Board accepts the application as a single, complete package, and it can arrive in person or by mail; the online Gateway account is used to start and track an application, while the notarized form and sealed documents still come to the office. Pick the channel that lets you keep proof of delivery.

• By mail. Send the full package to the North Carolina State Board of Dental Examiners, 2000 Perimeter Park Drive, Suite 160, Morrisville, NC 27560. Use a certified or trackable service so you have proof of the date it arrived.
• In person. Drop off the package at the same Morrisville address during business hours and ask for a date-stamped receipt.
• By phone for forms only. You can call (919) 678-8223 or email info@ncdentalboard.org to request a paper application, but the completed form is not filed by phone.
• Fax. The office fax is (919) 678-8472, but a notarized application with glued photo and sealed transcripts cannot be properly filed by fax, so use it only for documents the Board tells you to fax.

On fees and payment, the licensure by credentials fee runs $2,000.00 and is non-refundable and non-transferable, while exam and hygiene fees differ, so confirm the current amount on the Board’s fee schedule under 21 NCAC 16M .0101. Pay by certified check, personal check, or money order made out to the NC State Board of Dental Examiners, and never send cash. Expect a review of up to 90 days, and keep a full copy of your package plus your mailing receipt as your proof of filing.

What Happens After You File

Once the Board receives your package, staff log it and check whether it is complete; if anything is missing, they return the package with a $10.00 processing fee and the file is not active until you resubmit. The clock that matters most is the one-year window, because 21 NCAC 16B .0301(d) says any application not completed within one year is disregarded as expired, with no refund.

If the file is complete, the Board runs your SBI fingerprint check, pulls your sealed transcripts and exam scores, and verifies your license status in other states. This investigation is why the Board says the process can take up to 90 days, and a hit on the background check or a gap in your answers can extend it. The application is a continuing one, so you must update the Board in writing within 10 business days if your address or any answer changes.

When everything clears, the Board issues your license and you may begin practicing in North Carolina. Remember that obtaining a license through fraud or false statements leads to revocation under 21 NCAC 16B .0301(f), even if the lie is found years later, so accuracy now protects your career for good.

Mistakes to Avoid When Filling Out the Form

Each error below has stalled real applications, and the consequence follows the description.

• Stapling the photo instead of gluing it; the Board treats it as non-compliant and the file is flagged incomplete.
• Using a Polaroid or casual snapshot; the photo is rejected and your package is held.
• Signing the notary block before seeing the notary; the application is invalid and must be redone.
• Sending transcripts in an opened envelope; the Board cannot accept them, so your education is unverified.
• Leaving the county field blank in your address; the SBI background check tied to your address slows down.
• Listing a school email that expires; the Board’s follow-up bounces and your file goes quiet.
• Skipping short or part-time jobs in the 10-year history; the gaps prompt a request for more information.
• Checking No to other names when your maiden name differs from your diploma; it looks like concealment and triggers review.
• Hiding a dismissed or expunged charge; the SBI check surfaces it and non-disclosure becomes grounds for denial.
• Transposing a digit in your Social Security number; the background check attaches the wrong record or stalls.
• Forgetting the NPDB report when you held an out-of-state license; the credentials file is incomplete.
• Sending cash for the fee; the Board returns it and the package sits until proper payment arrives.
• Letting the one-year window lapse; the application expires and your fee is gone with no refund.

Do’s and Don’ts

These quick rules keep your file moving.

Do: – Read the rules in 21 NCAC 16B first, because submitting the wrong route can cost you the fee. – Gather every sealed document before mailing, since the Board needs a complete package on arrival. – Answer every question fully, because the form treats blanks as incomplete. – Keep a full copy of your package, so you can prove what you sent if mail is lost. – Use trackable mail, because proof of the delivery date protects your one-year window. – Update the Board within 10 business days of any change, since the application is continuing.

Don’t: – Don’t separate the form pages, because the instructions forbid it and loose pages get lost. – Don’t guess on dates or numbers, since a notarized error is a sworn false statement. – Don’t send cash, because the Board will not process it. – Don’t omit a past license or charge, since the NPDB and SBI checks will find it. – Don’t sign before the notary, because an un-witnessed signature voids the form. – Don’t assume the fee is refundable, because it is explicitly non-refundable and non-transferable.

Pros and Cons of Filing on Your Own vs. With Help

Many applicants file alone, while others hire a licensing service or attorney, especially when their record is complex.

Pros of filing on your own: – You save the cost of a service, which can run hundreds of dollars. – You learn the rules firsthand, which helps at renewal time. – You control the timeline and can mail the moment your documents arrive. – You keep your private health and legal details in fewer hands. – You avoid miscommunication that can happen when a third party fills boxes for you.

Cons of filing on your own: – You may misread a field and trigger a return with a $10.00 fee. – A discipline or criminal-history disclosure is hard to frame well without guidance. – Foreign-training and credentials files have extra documents that are easy to miss. – A small slip can cost weeks of delay during the 90-day review. – You bear the full risk of the non-refundable fee if the package is rejected.

FAQs

Do I need to graduate from a CODA-accredited dental school to apply? Yes. The Board requires a degree from a CODA-accredited dental school, and your sealed transcript must confirm it before the application is complete.

Do I have to take a clinical exam for licensure by credentials? No. The credentials route under G.S. 90-36 lets qualified out-of-state dentists skip the full clinical exam, though you still pass the written jurisprudence and infection-control exams.

Do I write my maiden name or married name in Question 1? Yes. Write your full current legal name in Question 1, then disclose your maiden name in Question 6 so the Board can match your diploma to your license.

Do I list expired or inactive licenses in Question 21? Yes. List every dental license you have ever held in Question 21, including lapsed and inactive ones, because the NPDB report will reveal any you leave out.

Do I have to glue the photo, or can I staple it? Yes, you must glue it. The form specifically says the photo must be glued and not stapled, and a stapled photo is treated as non-compliant.

Do I include traffic tickets in the Question 15 criminal-history answers? No. You may exclude minor traffic violations, but only those unrelated to alcohol or drugs; anything alcohol- or drug-related must be disclosed.

Do I need a Notary Public to complete the application? Yes. The form must be notarized under 21 NCAC 16B .0301(b), and you must sign the affidavit in front of the notary, not before.

Do I get my fee back if my application is denied? No. The application fee is non-refundable and non-transferable, even if the Board denies you or offers a consent order.

Do foreign-trained dentists qualify to apply in North Carolina? Yes. Foreign-trained dentists may apply if they complete a CODA-accredited U.S. program and meet exam requirements, and they must attach proof of immigration status under Question 7.

Do I have to fill in the county on my address lines? Yes. The address fields ask for county, and leaving it blank can slow the SBI background check that is tied to your residence.

Do I need a CPR certificate to apply? Yes. A copy of an unexpired CPR certificate is required under 21 NCAC 16B .0301(a)(49), and an expired card makes the file incomplete.

Do I have to disclose a charge that was dismissed or expunged? Yes. Question 15 asks about arrests and charges, not just convictions, so disclose them; the SBI check may surface them and non-disclosure is grounds for denial.

Do I lose my application if I take too long to finish it? Yes. Under 21 NCAC 16B .0301(d), any application not completed within one year is disregarded as expired, and your fee is not refunded.

Do I have to report a new address after I file? Yes. You must notify the Board in writing within 10 business days of any address change, because the application is treated as a continuing one.