A dental hygienist shall submit a completed Board-approved application with the Board to be recognized as qualified to prescribe and administer medication. Recognized as Qualified to Prescribe and Administer Medication. Not Certified or Otherwise Recognized in Another State. A dental hygienist who applies to be recognized as qualified to prescribe and administer medication and who is not certified or otherwise recognized in another state to prescribe and administer medication shall submit to the Board: A completed Board-approved application; Proof of completion of a 4-hour Board-approved course of instruction in prescribing and administering medication in the form of a letter from an accredited dental hygiene program indicating that the applicant has: Successfully completed the course; and Received an overall passing grade of at least 75 percent in the course’s written examination; A fee as specified in COMAR 10.44.20; and Any other pertinent documents or information requested by the Board. Recognized as Qualified to Prescribe and Administer Medication by Virtue of Being Recognized in Another State. A dental hygienist who applies to be recognized as qualified to prescribe and administer medication by virtue of being certified or otherwise recognized as qualified in another state to prescribe and administer medication shall submit to the Board: A Board-approved application; A certified copy of the dental hygienist’s most recent license or certification from the state of licensure or certification, indicating that the dental hygienist holds a current license or certification to prescribe and administer medication; An affidavit indicating that the dental hygienist has within the 2-year period immediately preceding the date of the application successfully: Prescribed medication to at least 100 patients without complications; and Administered medication to at least 100 patients without complications; A fee as specified in COMAR 10.44.20; and Any other pertinent documents or information requested by the Board. The affidavit referenced in §B(2)(c) of this regulation shall contain the name, business address, and business telephone number of each dentist who supervised the applicant’s prescribing and administering medication as well as a statement indicating whether the dentist is currently practicing dentistry, is retired, or is deceased. The letter from the accredited dental hygiene program referenced in §B(1)(b) of this regulation shall: Be on the letterhead of the accredited dental hygiene program; Contain a raised embossed school seal; and Contain the original signature of either: The dean of the accredited dental hygiene program; or The head of the dental hygiene department.