NDA’s 2011 Summer Destin-ation

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Thursday, June 2nd – Saturday, June 4th

"Oral Pathology” Featuring Dr. Jim Weir
Friday, June 3rd 9:00am – 12:00pm
Saturday, June 4th 9:00am – 12:00pm

6 hours CE Credit
                       
Program Venue: Sandestin Golf and Beach Resort, Destin, FL
9300 Emerald Coast Parkway West
                                   
Accommodations: Special Rates Available for NDA Members

Registration:    By fax- Complete form below and fax to (985) 875-9000
                                   
       By mail- Complete form below and mail to:

NDA
Post Office Box 8925
Mandeville, LA  70470

By email-Send the information requested below to: northlakeda@gmail.com  (Please list “NDA” on the subject line)

Course Registration

Doctor’s Name: _____________________________________
Address: ___________________________________________
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Phone: (____) ______________  Fax: (____) ______________
email: _____________________________________________