Assistant Certificate PDF

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

STATE OF MISSISSIPPI STATE OF MISSISSIPPI

Board of Dental Examiners


Board of Dental Examiners 600 East Amite Street, Suite 100 Jackson, MS 39201-2801

600 East Amite Street, Suite 100 Jackson, MS 39201-2801


SHEENA PERRY GORDON RPH
THIS CERTIFIES that the undersigned has paid registration fees as required by law to renew his/her radiology
permit in the State of Mississippi and is entitled to administer dental radiographs for the year November 01, 2018 Radiology Permit Permit Number: 7178-07
through October 31, 2020.

Expires October 31, 2020 T. Delton Moore, DDS

Status: ACTIVE
CERTIFICATE
SHEENA PERRY GORDON RPH Permit Number: 7178-07

Signature of Permit Holder T. Delton Moore, DDS


11/05/2018 The Permit Holder Is Responsible for Notifying the Board of any Change of Address

You might also like