1. (a) The board will issue a license by credentials to practice dental hygiene under this section to an applicant who meets the requirements of AS 08.32.014, 08.32.030, and this section.

2. (b) An applicant for license under this section shall submit to the department

   1. (1) a complete, notarized application on a form provided by the department;
   2. (2) the applicable fees established in 12 AAC 02.190;
   3. (3) an authorization from the applicant for release of the applicant's records to the department;
   4. (4) an affidavit from the applicant that lists the license number and the name of the jurisdiction for all dental hygiene licenses that the applicant holds or has ever held in any jurisdiction;
   5. (5) repealed 3/5/2023;
   6. (6) a copy of a current certification in cardiopulmonary resuscitation (CPR) techniques for the applicant that meets the requirements of 12 AAC 28.920;
   7. (7) a copy of the applicant's certificate of examination that meets the requirements of AS 08.32.014(a)(1)(B);
   8. (8) a copy of the applicant's certificate of examination that meets the requirements of AS 08.32.014(a)(1)(C);
   9. (9) as required under 12 AAC 28.908(a), a statement from the applicant certifying the applicant will adhere to the ethical standards specified in 12 AAC 28.905(a);
   10. (10) an affidavit from the applicant stating the applicant is not impaired to an extent that affects the applicant's ability to practice dental hygiene; and

   11. (11) an affidavit from the applicant documenting

       1. (A) the dates and locations where the applicant has practiced dental hygiene during the five years immediately preceding the date of application;
       2. (B) repealed 3/5/2023;

3. (c) In addition to the requirements of (a) and (b) of this section, an applicant for a license under this section shall arrange for and ensure the submission of

   1. (1) if the applicant is or has ever been employed as a dental hygienist with a federal agency, verification of the current status and disciplinary history from each federal agency where the applicant is or has been employed, sent directly to the department from the agency;
   2. (2) verification of the applicant's status and complete information regarding any disciplinary action or investigation taken or pending from all licensing jurisdictions where the applicant holds or has ever held a dental hygiene license, sent directly to the department from the licensing jurisdiction;
   3. (3) repealed 3/5/2023;
   4. (4) an official transcript sent directly to the department from the educational institution verifying graduation from a dental hygiene program that meets the requirements of AS 08.32.014(a)(1)(A).
4. (d) In addition to the requirements of this section, an applicant for a dental hygiene license must document completion of the jurisprudence examination prepared by the board, covering the provisions of AS 08.32, AS 08.36, and this chapter relating to the practice of dental hygiene, with a passing score of at least 70 percent.

(Eff. 1/22/2004, Register 169; am 5/5/2006, Register 178; am 12/5/2009, Register 192; am 12/15/2013, Register 208; am 3/11/2016, Register 217; am 5/1/2019, Register 230; am 2/19/2021, Register 237; am 3/5/2023, Register 245)

Authority: AS 08.32.014, AS 08.32.030, AS 08.32.070, AS 08.36.070