From: "Lopez, Jessica To:'• Subject: RE: DDS licensure: need a form Date: Mon, 09 Nov 2015 23:38:47 +0000 Attachments: initial_licensefet(JAN2015).pdf; Lic_app_-_2013.pdf Hi Dr. Shuliak, Please see attachment for requested application. Attachment: [Application for Issuance of License Number and Registration of Place of Practice] Thank you, Jessica Lopez Dental Board of California 2005 Evergreen Street, Ste. 1550 Sacramento, CA 95815 Privilege and Confidentially Notice: This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. The foregoing applies even if this notice is embedded in a message that is forwarded or attached. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. From: Karyna Shuliak Sent: Monday, November 09, 2015 8:43 AM To: DentalBoard@DCA Subject: DDS licensure: need a form Dear Sir or Madam, I am Dr. Karyna Shuliak, My DDS license has been approved. I need a new blank application form for issuance of license number and registration of place of practice. Can someone please send it to me, so that I can obtain my license. Thank you, Dr. Shuliak EFTA00573912