| COURSE ATTENDANCE VERIFICATION   | 
| Participant's Name: Jason Larsen | 
| State and License #: Texas 25790 | 
| Participant AGD ID#: Na | 
| Course: The 50 Shades of Gray – Defining Radiolucencies in Everyday Practice | 
| SPEAKERS: Dr. Parul Dua Makkar | 
| Educational Method: Self StudyCE Hours: 1 | 
| Educational Type: Self Study | 
| Course Date: October 23, 2023 | 
| AGD Code:550 Practice Management and Human Resources | 
| Verification Code: DFX-PDM1 | 
| Authorized Signature:  | 
|   | 
| PARTICIPANTS: 
        This activity has been planned and implemented in accordance with the standards | 
| Keep this form for your records. 
        AGD Members: Delivering Wow will submit attendance verification to the AGD on your behalf. | 
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