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4100 – Safe Body Art
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PR0547967
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Last modified
2/29/2024 9:42:27 AM
Creation date
4/27/2023 1:37:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING/PERMITS
RECORD_ID
PR0547967
PE
4120
FACILITY_ID
FA0027346
FACILITY_NAME
DIVINE EYE TATTOO & PERMANENT COSMETICS (VASQUEZ, STEVIE)
STREET_NUMBER
24
Direction
W
STREET_NAME
ELM
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
24 W ELM ST
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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AN JOA USOUNTY ENVIRONMENTAL HEALT DEPARTMENT <br /> S Q <br /> 1868 E.Hazelton Ave. •Stockton,CA 95205-6232 • Phone(209)46W420. <br /> Linda Tnrkatte,R.E.H.S.,.Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID#PT0025475 for Record ID#PR0541543 <br /> Valid From 7/1/2018 To 6/30/2019 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> .and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: VASQUEZ,STEVIE R <br /> DBA: IN 2 SKIN TATTOO&PIERCING <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: IN.2,SKIN TATTOO(VASQUEZ,STEVIE) Faciiity11D FA0023817 <br /> 2738 PACIFIC.AVE Account Io AR0044122 <br /> STOCKTON CA -95204 , Issued 5/2/2018 <br /> Billing Address: ATTN . VASQUEZ, STEVIE R <br /> IN 2 SKIN TATTOO& PIERCING <br /> 663 CANYON CREEK WAY <br /> GALT' CA 95632 <br /> 7027.rpt <br />
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