An applicant for a dental or a dental hygiene license shall submit the following to the Board: A completed application on a form provided by the Board; A recent photograph of the applicant not to exceed 3 inches by 3 inches accompanied by a notarized statement stating that “the photograph is a true photograph of me”; An original National Board Score Card; Certified proof of dental or dental hygiene education which contains the raised embossed school seal certifying its authenticity, except that letters from educational institutions on original letterhead, bearing an original signature, do not require a raised embossed seal; A certified ADLEX or ADHLEX score; Documentation of change of name if the name on any of the documents submitted to the Board differs from the applicant's name; and Any other documents or information pertinent to licensure required by the Board.