· I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS,...
4
Transcript of · I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS,...
![Page 1: · I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS, CA. 90211 Right to Revoke: You will have the right to revoke this Consent at any time](https://reader034.fdocuments.in/reader034/viewer/2022042308/5ed569956551673b635ad673/html5/thumbnails/1.jpg)
![Page 2: · I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS, CA. 90211 Right to Revoke: You will have the right to revoke this Consent at any time](https://reader034.fdocuments.in/reader034/viewer/2022042308/5ed569956551673b635ad673/html5/thumbnails/2.jpg)
![Page 3: · I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS, CA. 90211 Right to Revoke: You will have the right to revoke this Consent at any time](https://reader034.fdocuments.in/reader034/viewer/2022042308/5ed569956551673b635ad673/html5/thumbnails/3.jpg)
![Page 4: · I grant the right to the dentist to ... Address: 275 S. ROBERTSON BLVD STE G. BEVERLY HILLS, CA. 90211 Right to Revoke: You will have the right to revoke this Consent at any time](https://reader034.fdocuments.in/reader034/viewer/2022042308/5ed569956551673b635ad673/html5/thumbnails/4.jpg)