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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0546599
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Last modified
9/19/2024 3:28:21 PM
Creation date
6/27/2023 9:55:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING/PERMITS
RECORD_ID
PR0546599
PE
4110
FACILITY_ID
FA0026438
FACILITY_NAME
LODI MICRO CLINIC (FLEMING, CARLY)
STREET_NUMBER
755
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
755 S FAIRMONT ST
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Jasjit Kang, R.E.H.S, Director <br />ENVIRONMENTAL HEALTH <br />PERNHT TO OPERATE - 4110 -BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0027901 for Record ID # PR0546599 <br />Valid From 3/17/2021 To 6/3012021 <br />PERMITS TO OPERATE aze NOT TRANSFERABLE <br />and maybe SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: FLEMING, CARLY <br />DBA: CARLY FLEMING <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: LODI MICRO CLINIC (FLEMING, CARLY) Facility ID FA0026438 <br />755 S FAIRMONT ST Accountt <br />0 AR0050301 <br />LODI CA 95240 sued 3/1 912 0 21 <br />Biding Address: ATTN : FLEMING, CARLY <br />LODI MICRO CLINIC <br />2081 SYLVAN WAY APT 608 <br />LODI CA 95242 <br />�ozzrP� <br />
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