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ay have about the applicant I agree to send by certified mail in a confidential letter to the Board of Dental Examiners of the U.S. Virgin Islands. P.O. Address Please Print Name Personal Signature (Including. street & city) Known Since (Signatures arc required by not fewer than three citizens unrelated
f passport size, autographed across the back. • A certified check, bank money order or U.S. Postal money order in the amount of $65.00, payable to Government of the Virgin Islands. This fee is non-refundable. Page 1 of 10 EFTA_R1_02124412 EFTA02711062 • Chronology of professional activities from graduation to time of appl
ay have about the applicant I agree to send by certified mail in a confidential letter to the Board of Dental Examiners of the U.S. Virgin Islands. P.O. Address Please Print Name Personal Signature (Including. street & city) Known Since (Signatures arc required by not fewer than three citizens unrelated
f passport size, autographed across the back. • A certified check, bank money order or U.S. Postal money order in the amount of $65.00, payable to Government of the Virgin Islands. This fee is non-refundable. Page 1 of 10 EFTA_R1_02124467 EFTA02711094 • Chronology of professional activities from graduation to time of appl
ay have about the applicant I agree to send by certified mail in a confidential letter to the Board of Dental Examiners of the U.S. Virgin Islands. P.O. Address Please Print Name Personal Signature (Including street & city) Known Since (Signatures are required by not fewer than three citizens unrelated t
f passport size, autographed across the back. • A certified check, bank money order or U.S. Postal money order in the amount of $65.00, payable to Government of the Virgin Islands. This fee is non-refundable. Page 1 of 11 E FTA_R 1_02124827 EFTA02711308 • Chronology of professional activities from graduation to time of ap
Entities connected to both P.O. Address and Government of the Virgin Islands

Phoenix
LOCATIONthe District of Columbia
LOCATIONExaminer
ORGANIZATIONthe VI Department of Health
ORGANIZATIONCenter for Disease Control
ORGANIZATIONNational Board
ORGANIZATIONClinical Examination
ORGANIZATIONthe Dental Board Office
ORGANIZATIONGeneral Information on Application For Clinical Examination
ORGANIZATIONTime Allotment
ORGANIZATIONNO NATIONAL BOARD CREDIT
ORGANIZATIONCora Lapuz-Adrovel
PERSONDiploma
ORGANIZATIONThe National Board of Dental Examination Part H
ORGANIZATIONthe Computerized National Board Part II
ORGANIZATIONComputerized National Board Part II
ORGANIZATIONRea u irements
PERSONstreet & city
ORGANIZATION