Illinois 2023 2023-2024 Regular Session

Illinois Senate Bill SB2586 Enrolled / Bill

Filed 05/24/2024

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1  AN ACT concerning regulation.
2  Be it enacted by the People of the State of Illinois,
3  represented in the General Assembly:
4  Section 5. The Illinois Dental Practice Act is amended by
5  changing Sections 4, 18.1, and 23 and by adding Section 17.2 as
6  follows:
7  (225 ILCS 25/4)
8  (Section scheduled to be repealed on January 1, 2026)
9  Sec. 4. Definitions. As used in this Act:
10  "Address of record" means the designated address recorded
11  by the Department in the applicant's or licensee's application
12  file or license file as maintained by the Department's
13  licensure maintenance unit. It is the duty of the applicant or
14  licensee to inform the Department of any change of address and
15  those changes must be made either through the Department's
16  website or by contacting the Department.
17  "Department" means the Department of Financial and
18  Professional Regulation.
19  "Secretary" means the Secretary of Financial and
20  Professional Regulation.
21  "Board" means the Board of Dentistry.
22  "Dentist" means a person who has received a general
23  license pursuant to paragraph (a) of Section 11 of this Act and

 

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1  who may perform any intraoral and extraoral procedure required
2  in the practice of dentistry and to whom is reserved the
3  responsibilities specified in Section 17.
4  "Dental hygienist" means a person who holds a license
5  under this Act to perform dental services as authorized by
6  Section 18.
7  "Dental assistant" means an appropriately trained person
8  who, under the supervision of a dentist, provides dental
9  services as authorized by Section 17.
10  "Expanded function dental assistant" means a dental
11  assistant who has completed the training required by Section
12  17.1 of this Act.
13  "Dental laboratory" means a person, firm, or corporation
14  which:
15  (i) engages in making, providing, repairing, or
16  altering dental prosthetic appliances and other artificial
17  materials and devices which are returned to a dentist for
18  insertion into the human oral cavity or which come in
19  contact with its adjacent structures and tissues; and
20  (ii) utilizes or employs a dental technician to
21  provide such services; and
22  (iii) performs such functions only for a dentist or
23  dentists.
24  "Supervision" means supervision of a dental hygienist or a
25  dental assistant requiring that a dentist authorize the
26  procedure, remain in the dental facility while the procedure

 

 

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1  is performed, and approve the work performed by the dental
2  hygienist or dental assistant before dismissal of the patient,
3  but does not mean that the dentist must be present at all times
4  in the treatment room.
5  "General supervision" means supervision of a dental
6  hygienist requiring that the patient be a patient of record,
7  that the dentist examine the patient in accordance with
8  Section 18 prior to treatment by the dental hygienist, and
9  that the dentist authorize the procedures which are being
10  carried out by a notation in the patient's record, but not
11  requiring that a dentist be present when the authorized
12  procedures are being performed. The issuance of a prescription
13  to a dental laboratory by a dentist does not constitute
14  general supervision.
15  "Public member" means a person who is not a health
16  professional. For purposes of board membership, any person
17  with a significant financial interest in a health service or
18  profession is not a public member.
19  "Dentistry" means the healing art which is concerned with
20  the examination, diagnosis, treatment planning, and care of
21  conditions within the human oral cavity and its adjacent
22  tissues and structures, as further specified in Section 17.
23  "Branches of dentistry" means the various specialties of
24  dentistry which, for purposes of this Act, shall be limited to
25  the following: endodontics, oral and maxillofacial surgery,
26  orthodontics and dentofacial orthopedics, pediatric dentistry,

 

 

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1  periodontics, prosthodontics, oral and maxillofacial
2  radiology, and dental anesthesiology.
3  "Specialist" means a dentist who has received a specialty
4  license pursuant to Section 11(b).
5  "Dental technician" means a person who owns, operates, or
6  is employed by a dental laboratory and engages in making,
7  providing, repairing, or altering dental prosthetic appliances
8  and other artificial materials and devices which are returned
9  to a dentist for insertion into the human oral cavity or which
10  come in contact with its adjacent structures and tissues.
11  "Informed consent" means legally valid consent that is
12  given by a patient or legal guardian, that is recorded in
13  writing or digitally, that authorizes intervention or
14  treatment services from the treating dentist, and that
15  documents agreement to participate in those services and
16  knowledge of the risks, benefits, and alternatives, including
17  the decision to withdraw from or decline treatment.
18  "Impaired dentist" or "impaired dental hygienist" means a
19  dentist or dental hygienist who is unable to practice with
20  reasonable skill and safety because of a physical or mental
21  disability as evidenced by a written determination or written
22  consent based on clinical evidence, including deterioration
23  through the aging process, loss of motor skills, abuse of
24  drugs or alcohol, or a psychiatric disorder, of sufficient
25  degree to diminish the person's ability to deliver competent
26  patient care.

 

 

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1  "Nurse" means a registered professional nurse, a certified
2  registered nurse anesthetist licensed as an advanced practice
3  registered nurse, or a licensed practical nurse licensed under
4  the Nurse Practice Act.
5  "Patient of record", except as provided in Section 17.2,
6  means a patient for whom the patient's most recent dentist has
7  obtained a relevant medical and dental history and on whom the
8  dentist has performed a physical an examination within the
9  last year and evaluated the condition to be treated, including
10  a review of the patient's most recent x-rays.
11  "Dental responder" means a dentist or dental hygienist who
12  is appropriately certified in disaster preparedness,
13  immunizations, and dental humanitarian medical response
14  consistent with the Society of Disaster Medicine and Public
15  Health and training certified by the National Incident
16  Management System or the National Disaster Life Support
17  Foundation.
18  "Mobile dental van or portable dental unit" means any
19  self-contained or portable dental unit in which dentistry is
20  practiced that can be moved, towed, or transported from one
21  location to another in order to establish a location where
22  dental services can be provided.
23  "Public health dental hygienist" means a hygienist who
24  holds a valid license to practice in the State, has 2 years of
25  full-time clinical experience or an equivalent of 4,000 hours
26  of clinical experience, and has completed at least 42 clock

 

 

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1  hours of additional structured courses in dental education in
2  advanced areas specific to public health dentistry.
3  "Public health setting" means a federally qualified health
4  center; a federal, State, or local public health facility;
5  Head Start; a special supplemental nutrition program for
6  Women, Infants, and Children (WIC) facility; a certified
7  school-based health center or school-based oral health
8  program; a prison; or a long-term care facility.
9  "Public health supervision" means the supervision of a
10  public health dental hygienist by a licensed dentist who has a
11  written public health supervision agreement with that public
12  health dental hygienist while working in an approved facility
13  or program that allows the public health dental hygienist to
14  treat patients, without a dentist first examining the patient
15  and being present in the facility during treatment, (1) who
16  are eligible for Medicaid or (2) who are uninsured or whose
17  household income is not greater than 300% of the federal
18  poverty level.
19  "Teledentistry" means the use of telehealth systems and
20  methodologies in dentistry and includes patient diagnosis,
21  treatment planning, care, and education delivery for a patient
22  of record using synchronous and asynchronous communications
23  under an Illinois licensed a dentist's authority as provided
24  under this Act.
25  (Source: P.A. 102-93, eff. 1-1-22; 102-588, eff. 8-20-21;
26  102-936, eff. 1-1-23; 103-425, eff. 1-1-24; 103-431, eff.

 

 

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1  1-1-24; revised 12-15-23.)
2  (225 ILCS 25/17.2 new)
3  Sec. 17.2. Teledentistry.
4  (a) As used in this Section, "patient of record" means a
5  patient for whom the patient's most recent Illinois-licensed
6  dentist has obtained a relevant medical and dental history and
7  on whom the dentist has (i) performed a physical examination
8  within the last year; (ii) obtained relevant records that are
9  appropriate for the type of teledentistry service being
10  provided from an in-person examination within the previous 12
11  months, including a review of the patient's most recent
12  x-rays; or (iii) established a relationship with the patient
13  through an exchange of protected health information for the
14  purpose of providing emergency care, treatment, or services in
15  accordance with subsection (c).
16  (b) A dentist may only practice or utilize teledentistry
17  on a patient of record. A dentist practicing dentistry through
18  teledentistry is subject to the same standard of care and
19  practice standards that are applicable to dental services
20  provided in a clinic or office setting. A dentist may provide
21  and delegate dental services using teledentistry only under
22  the supervision requirements as specified in this Act for
23  in-person care. Prior to providing teledentistry services to a
24  patient, a dentist must obtain informed consent from the
25  patient as to the treatment proposed to be offered through

 

 

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1  teledentistry by the dentist. A dentist providing
2  teledentistry under this Section shall provide the patient
3  with the his or her name, direct telephone number, and
4  physical practice address. It is a violation of this Act for a
5  provider of dental services rendering care through
6  teledentistry to require a patient to sign an agreement that
7  limits in any way the patient's ability to write a review of
8  services received or file a complaint with the Department or
9  other regulatory agency. The Department shall adopt rules to
10  provide for the use of teledentistry in the State of Illinois.
11  (c) A dentist may treat a patient of record to provide
12  emergent care or conduct an initial consultation using
13  teledentistry for the purpose of treating or assessing for
14  acute pain, infection, injury, or any intraoral or perioral
15  condition that presents immediate harm or discomfort to the
16  patient for which treatment cannot be postponed. A provider of
17  dental services rendering emergent care or conducting an
18  initial consultation through teledentistry must direct the
19  patient to receive appropriate in-person care after the
20  provision of teledentistry services.
21  (225 ILCS 25/18.1)
22  (Section scheduled to be repealed on January 1, 2026)
23  Sec. 18.1. Public health dental supervision
24  responsibilities.
25  (a) When working together in a public health supervision

 

 

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1  relationship, dentists and public health dental hygienists
2  shall enter into a public health supervision agreement. The
3  dentist providing public health supervision must:
4  (1) be available to provide an appropriate level of
5  contact, communication, collaboration, and consultation
6  with the public health dental hygienist and must meet
7  in-person with the public health dental hygienist at least
8  quarterly for review and consultation;
9  (2) have specific standing orders or policy guidelines
10  for procedures that are to be carried out for each
11  location or program, although the dentist need not be
12  present when the procedures are being performed;
13  (3) provide for the patient's additional necessary
14  care in consultation with the public health dental
15  hygienist;
16  (4) file agreements and notifications as required; and
17  (5) include procedures for creating and maintaining
18  dental records, including protocols for transmission of
19  all records between the public health dental hygienist and
20  the dentist following each treatment, which shall include
21  a notation regarding procedures authorized by the dentist
22  and performed by the public health dental hygienist and
23  the location where those records are to be kept.
24  Each dentist and hygienist who enters into a public health
25  supervision agreement must document and maintain a copy of any
26  change or termination of that agreement.

 

 

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1  Dental records shall be owned and maintained by the
2  supervising dentist for all patients treated under public
3  health supervision, unless the supervising dentist is an
4  employee of a public health clinic or federally qualified
5  health center, in which case the public health clinic or
6  federally qualified health center shall maintain the records.
7  If a dentist ceases to be employed or contracted by the
8  facility, the dentist shall notify the facility administrator
9  that the public health supervision agreement is no longer in
10  effect. A new public health supervision agreement is required
11  for the public health dental hygienist to continue treating
12  patients under public health supervision.
13  A dentist entering into an agreement under this Section
14  may supervise and enter into agreements for public health
15  supervision with 4 public health dental hygienists. This shall
16  be in addition to the limit of 4 dental hygienists per dentist
17  set forth in subsection (g) of Section 18 of this Act.
18  (b) A public health dental hygienist providing services
19  under public health supervision may perform only those duties
20  within the accepted scope of practice of dental hygiene, as
21  follows:
22  (1) the operative procedures of dental hygiene,
23  consisting of oral prophylactic procedures, including
24  prophylactic cleanings, application of fluoride, and
25  placement of sealants;
26  (2) the exposure and processing of x-ray films of the

 

 

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1  teeth and surrounding structures; and
2  (3) such other procedures and acts as shall be
3  prescribed by rule of the Department.
4  Any patient treated under this subsection (b) must be
5  examined by a dentist before additional services can be
6  provided by a public health dental hygienist. However, if the
7  supervising dentist, after consultation with the public health
8  hygienist, determines that time is needed to complete an
9  approved treatment plan on a patient eligible under this
10  Section, then the dentist may instruct the hygienist to
11  complete the remaining services prior to an oral examination
12  by the dentist. Such instruction by the dentist to the
13  hygienist shall be noted in the patient's records. Any
14  services performed under this exception must be scheduled in a
15  timely manner and shall not occur more than 30 days after the
16  first appointment date.
17  (c) A public health dental hygienist providing services
18  under public health supervision must:
19  (1) provide to the patient, parent, or guardian a
20  written plan for referral or an agreement for follow-up
21  that records all conditions observed that should be called
22  to the attention of a dentist for proper diagnosis;
23  (2) have each patient sign a permission slip or
24  consent form that informs them that the service to be
25  received does not take the place of regular dental
26  checkups at a dental office and is meant for people who

 

 

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1  otherwise would not have access to the service;
2  (3) inform each patient who may require further dental
3  services of that need;
4  (4) maintain an appropriate level of contact and
5  communication with the dentist providing public health
6  supervision; and
7  (5) complete an additional 4 hours of continuing
8  education in areas specific to public health dentistry
9  yearly.
10  (d) Each public health dental hygienist who has rendered
11  services under subsections (c), (d), and (e) of this Section
12  must complete a summary report at the completion of a program
13  or, in the case of an ongoing program, at least annually. The
14  report must be completed in the manner specified by the
15  Department of Public Health Oral Health Section including
16  information about each location where the public health dental
17  hygienist has rendered these services. The public health
18  dental hygienist must submit the form to the dentist providing
19  supervision for his or her signature before sending it to the
20  Division. The Department of Public Health Oral Health Section
21  shall compile and publicize public health dental hygienist
22  service data annually.
23  (e) Public health dental hygienists providing services
24  under public health supervision may be compensated for their
25  work by salary, honoraria, and other mechanisms by the
26  employing or sponsoring entity. Nothing in this Act shall

 

 

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1  preclude the entity that employs or sponsors a public health
2  dental hygienist from seeking payment, reimbursement, or other
3  source of funding for the services provided.
4  (e-5) A patient who is provided services under a
5  supervision agreement by a public health dental hygienist as
6  described in this Section does not need to receive a physical
7  examination from a dentist prior to treatment if the public
8  health dental hygienist consults with the supervising dentist
9  prior to performing the teledentistry service.
10  (f) This Section is repealed on January 1, 2026.
11  (Source: P.A. 103-431, eff. 1-1-24.)
12  (225 ILCS 25/23) (from Ch. 111, par. 2323)
13  (Section scheduled to be repealed on January 1, 2026)
14  Sec. 23. Refusal, revocation or suspension of dental
15  licenses. The Department may refuse to issue or renew, or may
16  revoke, suspend, place on probation, reprimand or take other
17  disciplinary or non-disciplinary action as the Department may
18  deem proper, including imposing fines not to exceed $10,000
19  per violation, with regard to any license for any one or any
20  combination of the following causes:
21  1. Fraud or misrepresentation in applying for or
22  procuring a license under this Act, or in connection with
23  applying for renewal of a license under this Act.
24  2. Inability to practice with reasonable judgment,
25  skill, or safety as a result of habitual or excessive use

 

 

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1  or addiction to alcohol, narcotics, stimulants, or any
2  other chemical agent or drug.
3  3. Willful or repeated violations of the rules of the
4  Department of Public Health or Department of Nuclear
5  Safety.
6  4. Acceptance of a fee for service as a witness,
7  without the knowledge of the court, in addition to the fee
8  allowed by the court.
9  5. Division of fees or agreeing to split or divide the
10  fees received for dental services with any person for
11  bringing or referring a patient, except in regard to
12  referral services as provided for under Section 45, or
13  assisting in the care or treatment of a patient, without
14  the knowledge of the patient or his or her legal
15  representative. Nothing in this item 5 affects any bona
16  fide independent contractor or employment arrangements
17  among health care professionals, health facilities, health
18  care providers, or other entities, except as otherwise
19  prohibited by law. Any employment arrangements may include
20  provisions for compensation, health insurance, pension, or
21  other employment benefits for the provision of services
22  within the scope of the licensee's practice under this
23  Act. Nothing in this item 5 shall be construed to require
24  an employment arrangement to receive professional fees for
25  services rendered.
26  6. Employing, procuring, inducing, aiding or abetting

 

 

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1  a person not licensed or registered as a dentist or dental
2  hygienist to engage in the practice of dentistry or dental
3  hygiene. The person practiced upon is not an accomplice,
4  employer, procurer, inducer, aider, or abetter within the
5  meaning of this Act.
6  7. Making any misrepresentations or false promises,
7  directly or indirectly, to influence, persuade or induce
8  dental patronage.
9  8. Professional connection or association with or
10  lending his or her name to another for the illegal
11  practice of dentistry by another, or professional
12  connection or association with any person, firm or
13  corporation holding himself, herself, themselves, or
14  itself out in any manner contrary to this Act.
15  9. Obtaining or seeking to obtain practice, money, or
16  any other things of value by false or fraudulent
17  representations, but not limited to, engaging in such
18  fraudulent practice to defraud the medical assistance
19  program of the Department of Healthcare and Family
20  Services (formerly Department of Public Aid) under the
21  Illinois Public Aid Code.
22  10. Practicing under a false or, except as provided by
23  law, an assumed name.
24  11. Engaging in dishonorable, unethical, or
25  unprofessional conduct of a character likely to deceive,
26  defraud, or harm the public.

 

 

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1  12. Conviction by plea of guilty or nolo contendere,
2  finding of guilt, jury verdict, or entry of judgment or by
3  sentencing for any crime, including, but not limited to,
4  convictions, preceding sentences of supervision,
5  conditional discharge, or first offender probation, under
6  the laws of any jurisdiction of the United States that (i)
7  is a felony under the laws of this State or (ii) is a
8  misdemeanor, an essential element of which is dishonesty,
9  or that is directly related to the practice of dentistry.
10  13. Permitting a dental hygienist, dental assistant or
11  other person under his or her supervision to perform any
12  operation not authorized by this Act.
13  14. Permitting more than 4 dental hygienists to be
14  employed under his or her supervision at any one time.
15  15. A violation of any provision of this Act or any
16  rules promulgated under this Act.
17  16. Taking impressions for or using the services of
18  any person, firm or corporation violating this Act.
19  17. Violating any provision of Section 45 relating to
20  advertising.
21  18. Discipline by another U.S. jurisdiction or foreign
22  nation, if at least one of the grounds for the discipline
23  is the same or substantially equivalent to those set forth
24  within this Act.
25  19. Willfully failing to report an instance of
26  suspected child abuse or neglect as required by the Abused

 

 

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1  and Neglected Child Reporting Act.
2  20. Gross negligence in practice under this Act.
3  21. The use or prescription for use of narcotics or
4  controlled substances or designated products as listed in
5  the Illinois Controlled Substances Act, in any way other
6  than for therapeutic purposes.
7  22. Willfully making or filing false records or
8  reports in his or her practice as a dentist, including,
9  but not limited to, false records to support claims
10  against the dental assistance program of the Department of
11  Healthcare and Family Services (formerly Illinois
12  Department of Public Aid).
13  23. Professional incompetence as manifested by poor
14  standards of care.
15  24. Physical or mental illness, including, but not
16  limited to, deterioration through the aging process, or
17  loss of motor skills which results in a dentist's
18  inability to practice dentistry with reasonable judgment,
19  skill or safety. In enforcing this paragraph, the
20  Department may compel a person licensed to practice under
21  this Act to submit to a mental or physical examination
22  pursuant to the terms and conditions of Section 23b.
23  25. Gross or repeated irregularities in billing for
24  services rendered to a patient. For purposes of this
25  paragraph 25, "irregularities in billing" shall include:
26  (a) Reporting excessive charges for the purpose of

 

 

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1  obtaining a total payment in excess of that usually
2  received by the dentist for the services rendered.
3  (b) Reporting charges for services not rendered.
4  (c) Incorrectly reporting services rendered for
5  the purpose of obtaining payment not earned.
6  26. Continuing the active practice of dentistry while
7  knowingly having any infectious, communicable, or
8  contagious disease proscribed by rule or regulation of the
9  Department.
10  27. Being named as a perpetrator in an indicated
11  report by the Department of Children and Family Services
12  pursuant to the Abused and Neglected Child Reporting Act,
13  and upon proof by clear and convincing evidence that the
14  licensee has caused a child to be an abused child or
15  neglected child as defined in the Abused and Neglected
16  Child Reporting Act.
17  28. Violating the Health Care Worker Self-Referral
18  Act.
19  29. Abandonment of a patient.
20  30. Mental incompetency as declared by a court of
21  competent jurisdiction.
22  31. A finding by the Department that the licensee,
23  after having his or her license placed on probationary
24  status, has violated the terms of probation.
25  32. Material misstatement in furnishing information to
26  the Department.

 

 

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1  33. Failing, within 60 days, to provide information in
2  response to a written request by the Department in the
3  course of an investigation.
4  34. Immoral conduct in the commission of any act,
5  including, but not limited to, commission of an act of
6  sexual misconduct related to the licensee's practice.
7  35. Cheating on or attempting to subvert the licensing
8  examination administered under this Act.
9  36. A pattern of practice or other behavior that
10  demonstrates incapacity or incompetence to practice under
11  this Act.
12  37. Failure to establish and maintain records of
13  patient care and treatment as required under this Act.
14  38. Failure to provide copies of dental records as
15  required by law.
16  39. Failure of a licensed dentist who owns or is
17  employed at a dental office to give notice of an office
18  closure to his or her patients at least 30 days prior to
19  the office closure pursuant to Section 50.1.
20  40. Failure to maintain a sanitary work environment.
21  41. Failure to comply with the provisions of Section
22  17.2 of this Act.
23  All proceedings to suspend, revoke, place on probationary
24  status, or take any other disciplinary action as the
25  Department may deem proper, with regard to a license on any of
26  the foregoing grounds, must be commenced within 5 years after

 

 

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1  receipt by the Department of a complaint alleging the
2  commission of or notice of the conviction order for any of the
3  acts described herein. Except for fraud in procuring a
4  license, no action shall be commenced more than 7 years after
5  the date of the incident or act alleged to have violated this
6  Section. The time during which the holder of the license was
7  outside the State of Illinois shall not be included within any
8  period of time limiting the commencement of disciplinary
9  action by the Department.
10  All fines imposed under this Section shall be paid within
11  60 days after the effective date of the order imposing the fine
12  or in accordance with the terms set forth in the order imposing
13  the fine.
14  The Department may refuse to issue or may suspend the
15  license of any person who fails to file a return, or to pay the
16  tax, penalty or interest shown in a filed return, or to pay any
17  final assessment of tax, penalty or interest, as required by
18  any tax Act administered by the Illinois Department of
19  Revenue, until such time as the requirements of any such tax
20  Act are satisfied.
21  Any dentist who has had his or her license suspended or
22  revoked for more than 5 years must comply with the
23  requirements for restoration set forth in Section 16 prior to
24  being eligible for reinstatement from the suspension or
25  revocation.
26  (Source: P.A. 103-425, eff. 1-1-24.)

 

 

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1  Section 10. The Consumer Fraud and Deceptive Business
2  Practices Act is amended by adding Section 2EEEE as follows:
3  (815 ILCS 505/2EEEE new)
4  Sec. 2EEEE. Violations concerning teledentistry under the
5  Illinois Dental Practice Act. Any person who violates Section
6  17.2 of the Illinois Dental Practice Act commits an unlawful
7  practice within the meaning of this Act.

 

 

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