Illinois Dental Exam Form
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Hygienists may request an application for licensure from the department of financial and professional. Code 665) states all children in kindergarten, second,. Illinois department of public health. Code 665) states all children in kindergarten and the. Oral health status (check all that apply) £ yes.
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Proof of school dental examination form. Illinois department of public health. A licensed dentist must complete the examination, sign, and date this proof of. Please reference the illinois department of public health website to ensure you are using the current form. Web dental examination waiver form.
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Proof of school dental examination form. Last first middle birth date: Web the examination must have taken place within 18 months prior to may 15 of the school year. Illinois law (child health examination code, 77 ill. To be completed by dentist:
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Illinois department of public health, division of oral. Please reference the illinois department of public health website to ensure you are using the current form. The current forms are linked. To be completed by dentist: Web illinois department of public health proof of school dental examination form to be completed by the parent (please print):
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A licensed dentist must complete the examination, sign, and date this proof of. Illinois law (child health examination code, 77 ill. Web proof of school dental examination form. Health examination form, child :
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Web the examination must have taken place within 18 months prior to may 15 of the school year. Illinois law (child health examination code, 77 ill. To be completed by dentist: To be completed by the parent (please print):
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