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2012 IAO Annual Meeting San Juan, Puerto Rico U.S.A. Case Display/ Table Clinic Application Due by: April 5, 2012 (late applicants are subject to space availability)
Note: All items for a case display or a table clinic must be confined to a single tabletop and cannot overflow to the floor or wall.
Name:
Location (City, Country):
e-mail:
	General Dentist     Pediatric Dentist     Orthodontist Specialist     Other
I will present a Case Display	Yes      No
Case Title:
Summary:
I will present a Table Clinic:	Yes      No
Table Clinic Title:
Summary:

International Association for Orthodontics (IAO)
750 N Lincoln Memorial Dr., #422
Milwaukee, WI 53202 U.S.A.
+414.272.2757 ● Fax: +414.272.2754 ● WorldHeadquarters@iaortho.org