X-Ray Machine Inspection Report
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Inspector Name:
If a dentist has more than one inspection location, you must record each location separately
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Last NameFirst Name
Credentials
Business Name/Location
AddressCity
State
ZipPhoneInspection DateX-Ray Tubes InspectedX-Ray Tubes in ComplianceItems of Non-compliance
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DoeJohnDDSDental Center, Inc.123 Main StCheyenneWY82001(307) 555-55551/1/201555
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