234 CMR 4.03
Initial Dentist Licensure by Examination
The Board may grant a license by examination to an applicant, who is of good moral
character, has met all eligibility requirements and has submitted the following information to the
Board:
(1) An accurate, complete and signed application, as specified by the Board for that purpose;
Office of Administration and Finance, unless waived in accordance with M.G.L. c. 112, § 1B;
(3) An original transcript with the college seal stating the degree granted and the date of issue
from a CODA-accredited dental school or any successor accrediting agency approved by the
Board, or a letter including the college's seal signed by the appropriate authority attesting to the
applicant's degree and date of graduation;
(4) A physician's statement made after an examination conducted within one year of the date
of application, attesting to the health of the applicant and to any impairments that may affect the
ability of the applicant to practice dentistry;
(5) Documentation of a passing score on each of the following exams:
(a) Parts I and II of the ADA National Board Examination;
(b) The CDCA or other state or regional examination approved by the Board; and
(c) Massachusetts Dental Ethics and Jurisprudence Examination or a Board-approved
successor examination.
(6) Documentation of current BLS certification or CPR/AED certification, except an applicant
applying for an individual anesthesia permit shall provide documentation that complies with
234 CMR 6.00: Administration of Anesthesia and Sedation;
(7) A passport-size color photograph;
(8) A statement disclosing any and all disciplinary, civil, or criminal action taken or filed
against the applicant any time after reaching the age of majority and prior to the date of
application, with supporting documentation as the Board may require;
(9) Proof satisfactory to the Board of good moral character;
(10) An attestation, signed under pains and penalties of perjury, that the applicant has complied
with all state tax laws pursuant to M.G.L. c. 62C, § 49A and child support laws pursuant to
M.G.L. c. 119A, § 16(a); and
(11)
Proof satisfactory to the Board of completion of training required pursuant to
M.G.L. c. 94C, § 18(e) as a condition precedent for obtaining licensure.