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If not working, leave blank. If working, put notice period with current employer in days. Thanks

Generally, the practices are open until 6pm. Occasionally, we would need a doctor to stay late to accommodate a patient. We would ideally like to work at least one Saturday per month.

Please list all states in which you are licensed to practice dentistry. Example: TX 25555, NM 12345

On a scale of 1-5 with 1 being the lowest and 5 being the highest, please rate your proficiency.

On a scale of 1-5 with 1 being the lowest and 5 being the highest, please rate your proficiency.

If applying for a locum tenens opening, how far are you willing to travel?

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