Any person who practices the fitting or dispensing of hearing aids shall deliver to each person supplied with a hearing aid, by him or at his order or direction, a bill of sale which shall contain his signature and show the address of his regular place of practice and the number of his license, together with a description of the make and model of the hearing aid furnished, the serial number of the hearing aid furnished, and the amount charged therefor. The bill of sale shall also reveal the condition of the hearing device and whether it is new, used or rebuilt.