Provider Name: Ivoclar Vivadent, Inc.

Provider AGD ID#:218958

Provider Address:175 Pineview Drive
Amherst, NY 14228
ATTENDANCE VERIFICATION

Participant’s Name: Alfredo Ramirez Garcia

License #: N/A
Title: Carillas Refractarias
Speaker: Norberto Ruiz
Educational Method: Lecture
Course Code: 780
Course Date: 2021-08-14
Location: N/A
CE Hours: 1hr
Authorized Signature:

Keep this form for your records or you may submit to your respective affiliation.
DO NOT RETURN THIS TO IVOCLAR VIVADENT