Department of Dental Medicine
Evidenced Based Dental Care

Date: 02/09/2016

Affiliation/Organization/Institution & Department:

Company Contact First Name:

Company Contact Last Name:

Daytime Phone:

Email (COMPLETE Internet Email Address!!

Verify Email:

Mailing Address (Must match your billing address on your credit card statement):
Street Address:
Address cont.:
Address cont.:
State: Postal/Zip Code:

Your Position:

Department of Orthodontics & Pediatric Dentistry
Evidenced Based Dental Care
Lecturer: Dr. Fred Ferguson
Location: School of Dental Medicine, Room 195/196 Rockland Hall
CDE Credits: 3.0 CERP credits
5:30-6:00pm = Registration
6:00-9:00pm = Lecture

Fees :
    Dentists/Specialists: $50
    Dental Students/Residents/Dental Assistants/Dental Hygienists: $20

Please note: Refunds will only be issued ten or more days prior to a workshop. After that, credit will be given for a future workshop.

SECCT System developed by Last Modified 02/09/2016 03:27:11 PM