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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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STOCKTON
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4100 – Safe Body Art
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PR0536984
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COMPLIANCE INFO
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Entry Properties
Last modified
4/12/2023 3:34:52 PM
Creation date
7/3/2020 10:13:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0536984
PE
4120
FACILITY_ID
FA0021236
FACILITY_NAME
STUDIO, THE (HAAS, ROSEMARIE)
STREET_NUMBER
2441
Direction
S
STREET_NAME
STOCKTON
STREET_TYPE
ST
City
LODI
Zip
95240
APN
06241016
CURRENT_STATUS
02
SITE_LOCATION
2441 S STOCKTON ST STE 5
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0536984_2441 S STOCKTON_.tif
Tags
EHD - Public
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Page I of I <br /> ECPatient Information REIVED <br /> Pab(,W Name Sex DOB <br /> Haas, Rosemarie Female 4/3/1944 a Yo R01 <br /> ENVIRONMENTAL HEALTH <br /> PCP and Center PFPKA1T/9FRVlrFS <br /> Primary Care Provider Phone Center <br /> David William Duncan, MID 209-366-2007 None <br /> Immunizations Never Reviewed <br /> HEPATITIS B VACCINE 9/5/2012, 6/20/2012 <br /> Influenza Vac 3+yr 12/15/2010 <br /> Pneumovax ADULT 4/21/2010 <br /> ZOSTER(SHINGLES)VAC 6/4/2009 <br /> Varicella(Chicken pox) History <br /> No previous history of Varicella/Chicken pox. <br /> Sutter Gould Med!cal Foundation <br /> 1335 S. Fairmont Ave. <br /> Lodi. CA 95240 <br /> Printed by GREATHOUSE MA, LISA [HEFFLEL] at 9/5/2012 10:25:01 AM <br />
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