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COMPLIANCE INFO_VVVV
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0544301
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COMPLIANCE INFO_VVVV
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Entry Properties
Last modified
7/13/2023 10:02:16 AM
Creation date
3/18/2021 12:25:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0544301
PE
4110
FACILITY_ID
FA0025180
FACILITY_NAME
LUMIERE SPA (VRISMO, TANYA)
STREET_NUMBER
15
Direction
W
STREET_NAME
OAK
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
15 W OAK ST
P_LOCATION
02
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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SAN JOAQU*OUNTY VNVIRONMENTAL HEALIWEPARTMENT <br /> 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 •Phone(209)468-3420 <br /> Linda Turkatte,R.EAILS.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID#PT0026828 for Record ID#PR0544301 <br /> Valid From 3/29/2019 To 6/30/2019 <br /> s - <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: VRISMO,TANYA <br /> DBA: REVIVE BY TANYA <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />{ Regulated Facility: LUMIERE SPA(VRISMO, TANYA) Facility ib FA0025180 <br /> 15 W OAK ST /account io AR0047369 <br /> LODI CA 95240 issued 4/2/2019 <br /> Billing Address: ATTN VRISMO, TANYA <br /> LUMIERE SPA <br /> 1830 LAKESHORE DR <br /> LODI CA 95242 <br /> 702Zryt <br />
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