Forms for Licensure
The Missouri Dental Board ran the following article in their newsletter.
SEDATING PATIENTS FOR NON DENTAL RELATED PROCEDURES
It has been brought to the Board's attention that some dentists may be numbing a patient in the dental office and then allowing the patient to leave the office numb so s/he can go to a tattoo artist for permanent makeup applications. In part, the practice of dentistry is defined as the administration of an anesthetic in connection with dental services or dental operations or dental surgery. The practice of dentistry does not provide for the administration of an anesthetic for non-dental related procedures. If a complaint is filed with the Board and the dentist is found to be administering an anesthetic to allow for the patient to have a non-dental related procedure performed, such as the application of permanent makeup, this is cause for the Board to pursue disciplinary action against the licensee.
Effective January 1, 2009, all applications for an establishment license must include a "no tax due" letter from the Department of Revenue, pursuant to section 114.083.4,RSMO which states:
"In addition of the provisions of subsection 2 of this section, beginning January 1, 2009, the possession of a statement from the department of revenue stating no tax is due under sections 143.191 to 143.265 RSMo, or sections 144.010 to 144.510 RSMo shall also be a prerequisite to the issuance or renewal of any city or county occupation license or any state license required for conducting any business where goods are sold at retail. The statement of no tax due shall be dated no longer than ninety (90) days before the submission for application or renewal of the license."
You may obtain a tax clearance letter by visiting DOR Website, e-mailing firstname.lastname@example.org or calling the Department of Revenue at (573)751-9268.
Application for Practitioner License
Application for Establishment
Application for Temporary Establishment/ Temporary Practitioner License