Dental Therapist

​​​​​​​​​​​​​​​​​ ​Additional Resources

Other Forms

Statutes and Administrative Code

Continuing Education Information

Exam Information​

Offenses that May Result in Refusal, Bar, or Termination of Licensure

Related Links

Dentistry Examining Board

Orders and Disciplinary Actions

Conviction Self Report

Professional Assistance Procedure

Monitoring

File a Complaint

Wisconsin Emergency Assistance Volunteer Registry (WEAVR)​

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Now Live: Easier Online License Applications and ​Renewals!

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​LicensE is your online, self-guided occupational license application platform. 

Please review the helpful links below:

  • Find step-by-step instruction for license renewal here.
  • Find a list of license renewals available via LicensE in the chart on the LicensE Customer Information page.
  • Find all licenses available via LicensE, plus user guides and other resources, on the LicensE Customer Information page.
  • Anyone applying for an initial license for any of the credentials listed can apply at license.wi.gov.

Our LicensE Application Status Lookup tool makes it easier for employees, and helps academic advisors support students during the license application process. To access the Application Status Lookup tool, you will need the applicant's 10-digit PAR number. An applicant may provide the number to anyone who could support their application. Find more information in our news release about this tool. ​​

​​License Information​

Per Wis. Stat. § ​440.08 (2), the required renewal date for the Dental Therapist​ credential is 09/30/ each odd numbered year.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date. Cardiopulmonary resuscitation (CPR) and automated external defibrillator​(AED) certification must be current to practice dental therapy.


Pre-Credential Education Information

​General education requirements include satisfaction of one of the following.

  1. ​Graduation from an accredited Dental Therapy Education Program
  2. Dental Therapy Education Program was not accredited at the time of applicant graduation but meets both of the following:
    • ​The Dental Therapy Education Program was approved by the Minnesota Board of Dentistry on or before February 2, 2024.​
    • The program was accredited at the time you submitted your application to the Department (DSPS).
  3. Graduation from a Dental Therapy Education Program in this state that has received initial accreditation​ and becomes fully accredited within 4 years of the program's inception.​ 
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Application for Licensure
FormDescription
4117
Dental Therapist License Application
4118

Dental Therapist Professional Education Verification

2829Malpractice Suits or Claims Form (if applicable)
2252
​Convictions and Pending Charges (if applicable) 
​​3217
​​Application for Fee Reduction (Optional - If applying for a fee reduction in your credentialing fee, this form must accompany the application for the credential. Fee reduction does not apply to exam fees.)
​ OPTIONAL PRE-APPLICATION CONVICTION REVIEW (See Form 3085 below.)​​​
​3085​
​Application for Predetermination (Optional - Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other and you desire a review of your conviction record before applying for a credential.)​​


Renewal Information

Requirements

  • FEE (See Renewal Dates and Fees)
  • SIG (Signature regarding the completion of Continuing Education) (Included​​ in online renewal.) 
  • CPR (Current CPR/AED certification is required.)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or dsps@wisconsin.gov.

Renewal Method​

FormDescription
RDAF
Renewal Dates and Fees
​2254
​Convictions and Pending Charges (if applicable for renewal application) ​
R210Active Duty/Discharge Renewal Extension

2011 Wisconsin Act 210 ​(Effective June 1, 2012.)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship.  Please view Active Duty/Discharge Renewal Extension Form R210.