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Stole of Canford.-Heauh and We11at6 Agency DepaJment of Health se Maes
<br /> 3 7
<br /> Page of Pages
<br /> 1276-39
<br /> RADIOACTIVE MATERIAL LICENSE License Number:
<br /> 57
<br /> Supplementary Sheet Amendment Number:
<br /> 11. This license is subject to an annual fee for sources of radioactive material
<br /> authorized to be possessed at any one time as specified in Item 8 of this
<br /> license. The annual fee for this license is required by and muted in
<br /> accordance with Sections 30230-30232 of the California Radiation Control
<br /> Regulations and is also subject to an annual cost-of-living adjustment pursuant
<br /> to Section 113 of the California Health and Safety Code.
<br /> 12. The individuals named below is authorized the specific uses of radioactive
<br /> material described in Items 6, 7, 8, and 9 of this license as follows:
<br /> (a) J. David Bernard, M.D. Groups 1, 2, 3, 4, 5, and 9
<br /> (b) T. A. Thomas, M.D. Groups 1, 2, 3, 4 (I-131 only) , 5, and 9
<br /> (c) Laszlo B. Fodor, M.D. Groups 1, 2, 3, 4 (I-131 only) , 5, and 9
<br /> (d) Javad Jamshidi, M.D. Groups 1, 2, 3, 4 (I-131 only) , 5, and 9
<br /> (e) Daniel W. Terry, M.D. Groups 1, 2, 3, 4 (I-131 only) , 5, and 9
<br /> (f) Jack L. Funamura, M.D. Groups 1, 2, 3, 4 (I-131 only) , 5, and 9
<br /> (g) M. Lousie Del Paine, M.D. Groups 1, 2, 3, and 9
<br /> (h) Masanobu Kamigaki, M.D. Groups 1, 2, 3, and 9
<br /> (i) Lynett Hart, M.D. Group 6
<br /> (j) Henry Y. T. Wong, M.D. Groups 4 (P-32 only) , and 6
<br /> (k) Edward C. Greenleaf, M.D. Group 6
<br /> (1) Royce J. Biddle, M.D. Groups 1, 2, 3 and 9
<br /> (m) James D. Rooke, M.D. Groups 4 (thyroid therapy only) , and 5
<br /> (n) William L. Giese, M.D. Group 6
<br /> (o) Frank S. Callcott, M.D. Groups 1, 2, 3, 4, 5 and 9
<br /> (p) William N. Goner, M.D. Groups 1, 2, 3 and 9
<br /> (q) Virginia Lee Toombs, M.D. Groups 1, 2, 3 and 9
<br /> 13. Except as specifically provided otherwise by this license, the licensee shall
<br /> possess and use radioactive material described in Items 6, 7, and 8 of this
<br /> license in accordance with statements, representation, and procedures contained
<br /> in the documents listed below. The Department's regulation shall govern unless
<br /> the statements, representation, and procedures in the licensee's application
<br /> and correspondence are more restrictive than the regulation.
<br /> (a) The application with attachments dated September 28, 1987 and signed by
<br /> Jack L. Funamura.
<br /> (b) The letter with attachments dated October 6, 1988 and signed by Lawrence A.
<br /> Phillip.
<br /> (c) The letter with attachments dated November 18, 1988, signed by Jack L.
<br /> Funamura, M.D.
<br /> For the State Department of Health Services
<br /> April 21, 1994 3
<br /> Date: By:
<br /> Radlologic Health Branch
<br /> P.O. Box 942732
<br /> Sacramento, CA 94234-7320
<br /> RH 2551(Int)(1/91)
<br />
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