(B) Prior to the performance of a dental surgical procedure where there is no known medical problem, a dentist may perform a physical examination, review the patient medical history, and review the results of pertinent preoperative diagnostic studies prior to surgery in lieu of a physician upon:

1. (1) successful completion of a physical evaluation program or course at an accredited hospital or teaching institution, and
2. (2) board certification or eligibility by the American Board of Oral and Maxillofacial Surgery or by the American Board of Pedodontics.