OSF Saint Francis Medical Center

Peoria, Illinois

Dental Residency Application

Application Requirements:

  1. The applicant must have completed or be in the process of completing a dental degree program at a school accredited by the American Dental Association.
  2. Applicant must be eligible for Illinois permanent residency status.
  3. Applicant must complete and submit the attached application and requested enclosures.

Note: If accepted into the program, applicant must have reliable transportation due to the need to travel between multiple teaching locations

For additional information on the application process, please call Dr. Paul Amodeo, at 309-624-9741.

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A member of the Admissions and Selection Committee may attempt to contact you by telephone sometime during the application process. The purpose of this call will be to conduct an informal interview and/or to advise you of the status of your application. Please be sure the phone numbers above are accurate.

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Current Address

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Permanent Mailing Address

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Education and Training











Undergraduate College(s)
















Confidential Information








Licensed to Practice Dentistry













Certification

I understand that withholding information requested on this application or giving false information will cause me to be ineligible for admission or subject to dismissal. With this in mind, I certify that the forgoing statements are correct and complete. I further certify that if accepted for admission, I shall comply with the rules of OSF Saint Francis Dental General Practice Residency Program

Attachments







Application Fee

Please send a check or money order for $50.00 [not refundable] payable to OSF Saint Francis Medical Center to: Dr. Paul Amodeo, Director Dental General Practice Residency OSF Saint Francis Medical Center Allied Building - G-19 320 E. Armstrong Avenue Peoria, IL 61603


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