1. A. An applicant who has passed the ADHLEX with a score of 75 or greater in each required section shall submit the following to the Board:

   1. (1) A completed application on a form provided by the Board;
   2. (2) A photograph of the applicant not to exceed 3 inches by 3 inches accompanied by a notarized statement stating that “the photograph is a true photograph of me”;
   3. (3) An original National Board Score Card;
   4. (4) Certified proof of dental hygiene education which contains the raised embossed school seal certifying its authenticity, except that letters from educational institutions on original letterhead, bearing an original signature, do not require a raised embossed seal;
   5. (5) A certified examination score of the ADHLEX and, if requested by the Board, a specific point breakdown by procedure including penalty deductions if available;

   6. (6) A certified letter with a raised embossed seal from the dental hygiene licensing authority of each state in which the applicant holds an active dental hygiene license or ever held an active dental hygiene license indicating that the license is or was in good standing and that the applicant:

      1. (a) Is not being investigated;
      2. (b) Does not have charges pending against the applicant's license;
      3. (c) Has not been disciplined; and
      4. (d) Has not been convicted or disciplined by a court of any state or country for an act that would be grounds for disciplinary action under Health Occupations Article, §4-315, Annotated Code of Maryland;
   7. (7) Documentation of change of name if the name on any of the documents submitted to the Board differs from the applicant's name; and
   8. (8) Any other documents or information pertinent to licensure required by the Board.

2. B. An applicant who has not passed the ADHLEX shall submit the following to the Board:

   1. (1) A completed application on a form provided by the Board;
   2. (2) A photograph of the applicant not to exceed 3 inches by 3 inches accompanied by a notarized statement stating that “the photograph is a true photograph of me”;
   3. (3) An original National Board Score Card;
   4. (4) Certified proof of dental hygiene education which contains the raised embossed school seal certifying its authenticity, except that letters from educational institutions on original letterhead, bearing an original signature, do not require a raised embossed seal;

   5. (5) A certified letter with a raised embossed seal from the dental hygiene licensing authority of each state in which the applicant holds an active dental hygiene license or ever held an active dental hygiene license indicating that the license is or was in good standing and that the applicant:

      1. (a) Is not being investigated;
      2. (b) Does not have charges pending against the applicant's license;
      3. (c) Has not been disciplined; and
      4. (d) Has not been convicted or disciplined by a court of any state or country for an act that would be grounds for disciplinary action under Health Occupations Article, §4-315, Annotated Code of Maryland;
   6. (6) A notarized affidavit or other evidence satisfactory to the Board indicating that for the 3 preceding years the applicant has been actively engaged in practicing dental hygiene for at least 150 hours on average per year;
   7. (7) Documentation of change of name if the name on any of the documents submitted to the Board differs from the applicant's name; and
   8. (8) Any other documents or information pertinent to licensure required by the Board.

Authority: Health Occupations Article, §§4-303.1(d) and 4-306, Annotated Code of Maryland

Effective date: August 1, 1983 (10:15 Md. R. 1351)

Recodified from COMAR 10.44.12 to 10.44.09

Regulation .01 recodified to Regulation .01-1 and the Preface recodified to Regulation .01 in November 1990

Regulation .01 amended effective April 19, 1999 (26:8 Md. R. 615)

Regulation .01-1 amended effective April 19, 1999 (26:8 Md. R. 615)

Regulation .02A amended effective September 3, 1990 (17:17 Md. R. 2081); April 19, 1999 (26:8 Md. R. 615)

Regulation .02B amended effective April 19, 1999 (26:8 Md. R. 615); December 23, 2002 (29:25 Md. R. 1984)

Regulation .02C adopted effective September 3, 1990 (17:17 Md. R. 2081)

Regulation .02C amended effective September 17, 2001 (28:18 Md. R. 1621)

Regulation .02C repealed effective December 23, 2002 (29:25 Md. R. 1984)

Regulation .03 amended effective September 3, 1990 (17:17 Md. R. 2081); April 19, 1999 (26:8 Md. R. 615)

Regulation .04C adopted effective September 3, 1990 (17:17 Md. R. 2081)

Regulation .05A amended effective April 19, 1999 (26:8 Md. R. 615)

Regulations .01—.05 repealed and new Regulations .01 — .05 adopted effective December 22, 2003 (30:25 Md. R. 1848)

Regulation .02 amended effective October 24, 2005 (32:21 Md. R. 1708)

Regulation .03A amended effective October 24, 2005 (32:21 Md. R. 1708)

Regulations .01—.05 repealed and new Regulations .01 — .06 adopted as an emergency provision effective October 1, 2012 (39:22 Md. R. 1426); adopted permanently effective December 24, 2012 (39:25 Md. R. 1613)