650—11.3 (153) Dental licensure by credentials.
	 11.3(1) Applications for licensure by credentials to practice dentistry in this state shall be made on the form provided by the board and must be completely answered, including required credentials and documents.
	 11.3(2) Applications must be filed with the board along with:
	  a.   	 Satisfactory evidence of graduation with a DDS or DMD from an accredited dental college approved by the board or satisfactory evidence of meeting the requirements specified in rule 650—11.4(153).
	  b.   	 Evidence of successful completion of Parts I and II of the examination of the Joint Commission on National Dental Examinations, with resulting scores, or evidence of having passed a written examination during the last ten years that is comparable to the examination given by the Joint Commission on National Dental Examinations.
	  c.   	 A statement of any dental examinations taken by the applicant, with resulting scores.
	  d.   	 Evidence of a current, valid license to practice dentistry in another state, territory or district of the United States issued upon clinical examination.
	  e.   	 Certification by a state board of dentistry, or equivalent authority, from a state in which applicant has been licensed for at least three years immediately preceding the date of application and evidence of having engaged in the practice of dentistry in that state for three years immediately preceding the date of application or evidence of three years of practice satisfactory to the board.
	  f.   	 Certification by the state board of dentistry, or equivalent authority, from each state in which applicant has engaged in the practice of dentistry, that the applicant has not been the subject of final or pending disciplinary action.
	  g.   	 A statement disclosing and explaining any disciplinary actions, investigations, malpractice claims, complaints, judgments, settlements, or criminal charges, including the results of a self-query of the National Practitioners Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB).
	  h.   	 The nonrefundable application fee for licensure by credentials, plus the fee for the evaluation of the fingerprint packet and the criminal history background checks by the Iowa division of criminal investigation (DCI) and the Federal bureau of Investigation (FBI), as specified in 650—Chapter 15.
	  i.   	 Evidence that the applicant possesses a valid certificate in a nationally recognized course in cardiopulmonary resuscitation.
	  j.   	 Evidence of successful completion of the jurisprudence examination administered by the board of dental examiners.
	  k.   	 A photograph of the applicant suitable for positive identification.
	  l.   	 A completed fingerprint packet to facilitate a criminal history background check by the DCI and FBI.
	 11.3(3) The board may require a personal appearance or may require any additional information relating to the character, education, and experience of the applicant.
	 11.3(4) The board may also require such examinations as may be necessary to evaluate the applicant for licensure by credentials.
	 11.3(5) Applications must be signed and notarized attesting to the truth of the statements contained therein.
This rule is intended to implement Iowa Code chapters 147 and 153.
[ARC 9218B, IAB 11/3/10, effective 12/8/10]