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Get OH Approval Form For A Dental Hygienist Practicing 1999-2024

E DENTIST IS NOT PHYSICALLY PRESENT NAME OF DENTAL HYGIENIST LICENSE NUMBER EMPLOYING DENTIST LICENSE NUMBER EXPERIENCE Please list at least two (2) years and three thousand (3,000) hours of experience in the practice of dental hygiene (attach all supporting documentation to this form): MEDICAL EMERGENCY RECOGNITION COURSE TITLE OF COURSE WHERE TAKEN SPONSOR DATE CREDIT HOURS Please attach all supporting documentation or a copy of certificate of course completion to this form. CPR CERTI.

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