FORM OF APPLICATION FOR RENEWAL OF REGISTRATION OF DENTISTS/DENTAL HYGINISTS/DENTAL MECHANICS
UNDER SECTION 39 (1) OF THE DENTISTS ACT, 1949 (XVI OF 1948).

Note: Fill all details before going for renewal status.

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AS PER DCI LETTER NO. DATED FOR INFORMATION PLEASE CLICK HERE NO.DE-101-201310150 DATEDTHE 30.10.2013

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Reason For Not Renewed more than 5 years

I undersigned Reg. No. I have not done my registration renewal from the year , as

I am a Citizen of India. I have not done any unethical practice nor committed any breach of Regulation 6 or any other Regulations of the Dentists (Code of Ethics) Regulations,1976 and Regulation 8 or any other Regulations of the Revised Dentists (Code of Ethics) Regulations,2014 till date, and in case any complaint of unethical practices indulged by me or breach of any Regulations 6 or any other Regulations of the Dentists (Code of Ethics) Regulations,1976 and Regulation 8 or any other Regulations of the Revised Dentists (Code of Ethics) Regulations,2014 during the said period come to the notice of the Maharashtra State Dental Council, Mumbai, I will be wholly responsible and accountable for the same as per law.