Application Form

Name *

  

Date of Birth *

Sex *

Professional Qualification*

Name of DCI recognized College where Masters degree was completed in the specialty of Endodontics*

Year and month of masters degree completion*

Postal Address*

Email Address*

Phone

Mobile*

Details of cheque/dd for application fee amount of Rs 5000/- favoring "Indian Board of Endodontics" payable at Chennai

Bank Name

Cheque / DD No.

Additional information / Query

OR

Name : Indian Board of Endodontics
Bank: HDFC
Branch: Anna Nagar, Chennai, India
Account Number: 50100035643849
RTGS/NEFT IFSC code: HDFC0000017

If availed NEFT Bank Transfer, transaction number

Please Attach Scan Copies

MDS degree certificate in the specialty of endodontics/equivalent from a DCI recognized University in India*

1.

DCI registration certificate for BDS and MDS*

2.

Mark sheets of final year MDS exam*

3.

Active Membership certificate of Indian Endodontic Society*

4.

Answer the simple Question

5 + 9 = *

    IBE Office Bearers

  • Chairman
    Dr Anil Kohli
  • General Secretary
    Dr V Gopikrishna
  • Director
    Dr Vivek Hegde
  • Director
    Dr Sanjay Miglani
  • Ex-Officio Members

  • President – IES
  • Secretary General – IES
  • International Advisors

  • Dr James L Gutmann
    Baylor College of Dentistry, USA
  • Dr Anil Kishen
    University of Toronto, Canada
  • Dr Hagay Shemesh
    ACTA University, Netherlands
  • Dr Zvi Metzger
    Tel Aviv University, Israel
  • Dr Meetu R Kohli
    University of Pennsylvania, USA

Search for your nearest Endodontist