Form

Register me for Fotona Laser Masters Module I
LAHA Laser Masters Module I with Dr Scott Benjamin

🗓️ November 16-17, 2024 in Toronto

Sheraton Toronto Airport Hotel & Conference Centre
801 Dixon Road, Toronto, M9W 1J5

💲 Cost:
- If you recently purchased your LightWalker laser, we offer a complimentary registration for Module I for one dentist and 2 staff members.
- For extra or repeat dentists: $1495.00
- For each extra staff member: $495.00

Name of Practice*

Office Phone Number*

Street address*

City*

State/Region*

Country/Region*

Postal code*

First Name*

Last Name*

Job Designation

Email*

List any dietary requirements

If there are more staff members that will be attending the module, please select the amount and fill out their information fields. In case of having more than 4 people, please add them to the "Other Comments" section.*

Other Comments

Register me for Fotona Laser Masters Module ILAHA Laser Masters Module I with Dr Scott Benjamin🗓️ November 16-17, 2024 in TorontoSheraton Toronto Airport Hotel & Conference Centre801 Dixon Road, Toronto, M9W 1J5

Register me for Fotona Laser Masters Module I
LAHA Laser Masters Module I with Dr Scott Benjamin

🗓️ November 16-17, 2024 in Toronto

Sheraton Toronto Airport Hotel & Conference Centre
801 Dixon Road, Toronto, M9W 1J5