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
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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