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Mission of Mercy is a free adult dental clinic provided by volunteer dental professionals and a volunteer staff of several hundred people. Eastern Shore Mission of Mercy will be held in Salisbury Maryland on March 10th – 11th, 2017. Website http://www.easternshoremom.org/
This information is to help the application process for the Mission of Mercy for the Delaware dentist and dental hygienist. You do not have to bring anything but yourself and more volunteers. There are 3 basic steps.
- Go to http://www.rsvpbook.com/event.php?508669 and fill out registration on line information and select times to volunteer.
- If you do not have a Maryland license print out attachment for dentist or dental hygienist temporary volunteer form and fill out.
- FOR SECTION VIII- Malpractice Insurance- Click No- I have been told MOM will provide malpractice insurance for the event though R.K. Tongue insurance company. You do NOT have to fill out the Malpractice Insurance Affidavit.
- Application must get notarized
- Mail this form to address on application form
- Maryland requires written verification from Delaware about your license status. Print and fill out attached Verification Request Form. THIS FORM GETS MAILED TO DELAWARE BOARD OF DENTISTRY AND DENTAL HYGIENE ONLY.
Mail to and make out check to State of Delaware for $35.00Division of Professional Regulation Cannon Building
DELAWARE BOARD OF DENTISTRY AND DENTAL HYGIENE
861 Silver Lake Boulevard
Suite 203, Dover, DE 19904
Instructions for “WRITTEN LICENSE VERIFICATION REQUEST FORM – State of Delaware”
- James K. Kramer, DMD 302-436-5133
- State of Delaware professional regulation: 302-744-4500
- Maryland State Board of Dental Examiners
Ms. Sandy Sage 410-402-8510 and Ms. Patsy Sherwood 410-402-8509