Get Candidate Address And License Information - Mississippi State ...

This guide provides comprehensive instructions on how to accurately fill out the Candidate Address and License Information form for the Mississippi State Board of Dental Examiners online. Ensuring all details are correct is crucial for successful processing.

Follow the steps to complete your application effectively.

1. Click 'Get Form' button to access the form and open it in the editor.
2. Begin by entering your first name as you wish it to appear on your license. This name will be permanent and unchangeable, so ensure it is correct.
3. Next, provide your middle name and last name in the respective fields.
4. Fill in your city, state, and country of birth as these will be critical to your application.
5. Enter your date of birth in the designated format, ensuring accuracy.
6. In the place of residence section, provide your complete street address, including city, state, and zip code.
7. Include your home telephone number, ensuring it is appropriate for contact regarding your application.
8. Provide your social security number, which is required for identification purposes.
9. Indicate the dental school you attended and your date of graduation.
10. Fill in the address to which your license should be mailed. If uncertain of your address, consider using a permanent one, like a parent's or grandparent's.
11. Lastly, enter your email address for correspondence related to your application.
12. Once all fields are completed, review your information for accuracy. After confirmation, you may save changes, download, print, or share the form as needed.

Complete your documents online to ensure a smooth application process.