D.D.S., M.S.
D.D.S.
Endodontics
D.M.D.
D.D.S., Ph.D.
Periodontics
D.D.S., F.A.G.D.
B.D.S., M.D.S.
Oral Radiology
D.D.S., M.P.H.
General Medicine
B.D.S., D.M.D.
PA-C
D.O., F.A.A.O.
D.O.
Pharm.D.
PT, MS
PT, DPT, OCS
PT, D.P.T., M.H.S.
PT, Ph.D.
PT, DPT, MS
O.D., FAAO
Low Vision, ERG
O.D., FAAO, FSLS
Contact Lenses
O.D.
Ocular Disease
O.D., EdM, FAAO
Cornea/Contact Lens, Dry Eye
Cornea & Specialty Contacts
VT Therapy & Rehab, Pediatrics
M.S., CCC-SLP
Speech Pathology
Ph.D., CCC-SLP
M.A., CCC-SLP
This authorization will expire 1 year from 06/02/2023.
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With my digital signature below, I consent to the release of the above listed information / documents.
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