(1) A completed application must include the following:

(a) an original score card from the Joint Commission on National Dental Examinations showing the applicant's passage of the written examination administered by the Joint Commission on National Dental Examinations;

(b) certification of successful passage of a board approved regional clinical practical examination. Examinations shall be valid for the purpose of initial licensure for a period of five years from the date of successful passage of the examination;

(c) verification of graduation from a dental school accredited by the American Dental Association Commission on Dental Accreditation, or its successor. Verification must consist of an original dental school transcript and a diploma. The board may accept a letter from the dean of the school of dentistry, program director, or the dean's equivalent attesting to the program of study, and that graduation status was attained to process the application; however, a license will not be issued until the transcript is received in the board office;

(d) license verifications from all jurisdictions where the licensee has held or holds a license;

(e) a copy of a self-query of the National Practitioner Data Bank;

(f) a copy of the applicant's current CPR, ACLS, or PALS card;

(g) the jurisprudence examination fee; and

(h) the application fee.

(2) The applicant shall not be physically or mentally impaired by use of addictive drugs, alcohol, or any other drug or substance, or by mental or physical illness which in the determination of the board renders the individual unfit or incapable of practicing dentistry.

(3) Applicants shall successfully pass the jurisprudence examination with a final grade of at least 75 percent, prior to issuance of a license.

(4) Application material remains valid for one year from the time it is received in the office.