At the request of the state dental board, an authorizing dentist, or a dental hygienist or expanded function dental auxiliary who has been authorized to perform services in accordance with section 4715.431 of the Revised Code, shall make available to the board a list of all locations where the dental hygienist or expanded function dental auxiliary provided services, the locations where the hygienist or auxiliary is expected to provide services in the future, or both, as specified in the board’s request.