Change of Name
Important:
In order to update your name, you must submit supporting documentation such as a copy of your marriage license or divorce decree.
In order to update your name, you must submit supporting documentation such as a copy of your marriage license or divorce decree.
PLEASE MAIL TO:
ISSOURI DENTAL BOARD
P.O. Box 1367, Jefferson City, Missouri 65102-1367
Phone: (573) 751-0040
Fax: (573) 751-8216
Email: dental@pr.mo.gov