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Get AFFIDAVIT - Louisiana State Board Of Dentistry - Lsbd

(504) 568-8598 www.lsbd.org ENCLOSE APPROPRIATE FEE AND DOCUMENTATION INCLUDING COPY OF CURRENT CPR CARD WITH YOUR COMPLETED APPLICATION $50.00 NON-REFUNDABLE APPLICATION FEE This application consists of two sections. The first is to be filled out and signed by the applicant. The second is an affidavit to be completed by the dentist(s) under whose supervision six cases of induction and recovery were performed. All information must be completed. INCOMPLETE APPLICATIONS WILL BE RETURNED TO TH.

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