(1) A completed application and all required fees;

(2) Proof of graduation from a dental hygiene program accredited by the American Dental Association Commission on Dental Accreditation, recognized and approved by the board, together with documentary proof of the applicant's certification in the administration of intra-oral infiltration local anesthesia and intra-oral block anesthesia.

(3) Proof of a current active license issued by another state with licensing standards that are deemed by the board to be equal to or greater than the current requirements for a license in this State; provided that the license is not revoked, suspended, or otherwise restricted;

(4) Proof that the applicant has been lawfully engaged in the practice of dental hygiene for at least three years preceding the date of the application;

(5) Proof that the applicant has not been subject to disciplinary action by any jurisdiction in which the applicant is or has been previously licensed to practice dental hygiene; provided that if the applicant has been subjected to disciplinary action, the board shall review that action to determine if it warrants refusal to issue a license to the applicant;

(6) Proof that the applicant has no felony convictions of any kind that may affect the applicant's ability to render competent dental hygiene care;

(7) A letter of intent to engage in the practice of dental hygiene in the State within six months of licensure;

(8) An affidavit attesting to the applicant's professional standing and moral character from a dentist licensed and practicing in the State in which the applicant is licensed and engaged in practice; and

(9) Any other information required by the board to determine the applicant's fitness for licensure."