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Applications

ALL applicants for a Louisiana license (both full as well as restricted) are required to take a jurisprudence examination covering the Louisiana Dental Practice Act which can be found on our website.

APPLICANTS FOR A LICENSE BY CREDENTIALS OR A LICENSE BY AN EXAMINATION IN ANOTHER JURISDICTION: Please contact our office directly to obtain fingerprint cards and forms as they are unavailable from this website.

The following applications are available in Adobe Acrobat Format (*.pdf). Adobe offers a free plug-in viewer on its website.

• License Renewal

  • Dental Renewal Application

  • Dental Anesthesia Renewal Application

  • Hygiene Renewal Application

• Miscellaneous Publications and Forms

  • The Bulletin

  • HIV/HBV/HCV Reporting Form

  • Approved Radiology Course List

 

• Licensure by Credentials for Dentists & Hygienists

  • Licensure by Credentials Application

• Dental License by Outside Examination

  • Dental Outside Exam

• Dental Hygiene License by Outside Examination

  • Hygiene Outside Exam

• Application for Restricted License

  • Restricted Application

• Anesthesia Applications

  • Nitrous Oxide Application

  • Enteral Conscious Sedation Application

  • Parenteral Sedation Application

• Hygiene Anesthesia

  • Hygiene Anesthesia Application

  If you have taken a local anesthesia course outside Louisiana, and wish to apply for a local anesthesia permit, please also fill out the affidavit below and submit it with your local anesthesia application.
  
  

  • Local Anesthesia Affidavit

• Expanded Duty Dental Assistants

  • EDDA Application

• Change of Address
  • Change of Address Form

DEA Forms 
  DEA 224 New Application
  DEA - 106 Theft or Loss Report