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SAN JOAQUIOOUNTY ENVIRONMENTAL HEALAEPARTMENT <br /> 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 •Phone(209)468-3420 <br /> z; <br /> Linda Thrkatte,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID#PT0027183 ' for Record ID#PR0544984 <br /> Valid From 11/4/2019 To 6/30/2020 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE, <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: ADLER, DANA <br /> DBA: LODI MICRO CLINIC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LODI MICRO CLINIC (ADLER, DANA) Facility ID FA0025586 <br /> 755 S FAIRMONT AVE#C Account ID AR0048346 <br /> LODI CA 95240 Issued 11/15/2019 <br /> Bitting Address: ATTN : ADLER, DANA <br /> LODI MICRO CLINIC <br /> 203 PLAZA DR <br /> LODI CA 95240 <br /> 7o27.rpt <br />