Any non-profit corporation which is chartered for the purposes specified in Section 466.025(3), F.S., seeking a permit to employ a non-Florida licensed dentist who is a graduate of a dental school accredited by the Commission on Dental Accreditation of the American Dental Association shall file an Application for Non-Profit Corporation, DH-MQA 1223 (Revised 2/2025), which is hereby adopted and incorporated by reference and can be obtained at: HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-17977"http://www.flrules.org/Gateway/reference.asp?No=Ref-17977, with the Board which contains the following information:

1. (1) A certified copy of the non-profit corporation’s charter which establishes one or more of the purposes for the organization which are specified in Section 466.025(3), F.S., and proof of registration with the Internal Revenue Service as a nonprofit organization pursuant to 26 U.S.C. §501(c)(3).
2. (2) For non-profit corporations which provide dental care to indigent patients, statistics which establish that only indigent patients have been treated or admission criteria that only indigent patients will be treated. A description of the physical plant, available equipment and resources which establish that minimum standards of dentistry are or will be practiced at the facility.
3. (3) Any other information pertinent to the application which is requested by the Board.

Rulemaking Authority 466.004(4) FS. Law Implemented 466.025(3) FS. History–New 11-16-89, Formerly 21G-7.006, 61F5-7.006, 59Q-7.006, Amended 3-25-99, 6-12-00, 12-25-06, 9-11-23, 5-1-25.