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State of Collfornlo—Health and Welfare Agency ` <br />RADIOACTIVE MATERIAL LICENSE <br />Lodi Memorial Hospital <br />975 South Fairmont Avenue <br />Lodi, CA 95240 <br />Department of Health Services <br />Page 1 of 1 Pages <br />License Number: _j,35Q_-9- <br />Supplementary Sh e t Number: <br />X11 _ <br />AU 3 11992 <br />ENVIRONMENTAL LTH <br />J"I, JUAQUIN COUNTY RA IT /SERVICES <br />Attention: Roger P. Vincent, M.D. <br />Radiation Safety Officer <br />PUBLIC HEALTH SERVICES <br />ADMINISTRATION <br />In response to the letter with attachments dated July 15, 1992, signed by Roger P, <br />Vincent, M.D., License NuMber 1368-39 is hereby amended in part as follows: <br />12. The individuals named below are authorized the specific uses of radioactive <br />material described in Items 6, 7, 8 and 9 of this license as follows: <br />(a) Roger P. Vincent, M.D. <br />(b) Dennis D. Jacobsen, M.D. <br />(c) Patricia A. Bell, M. D. <br />(d) Henry Y.P. Wong, M.D. <br />(e) Edward C. Greenleaf, M.D. <br />(f) Frank M. Hartwich, M.D. <br />(g) R. Branden Rankin, III, M.D. <br />Groups <br />1, <br />2, <br />3, 4, 6 (Sr 90 only), and 9 <br />G=roups <br />1, <br />2, <br />3, 4, 6 (Sr 90 only), and 9 <br />Groups <br />1, <br />2, <br />3 and 9 <br />Group 6 <br />Groups 1, 2, 3, 4 (I-131 only), and 9 <br />Groups 4 (I-131 only), 6 (Sr 90 only), <br />and 9 <br />(h) Patricia K. Richardson, M.D. Groups <br />(i) Grant W. Rogero, M. D. Groups <br />Date; August 15, 1992 <br />PH 2551 (In t.) (1/91) <br />1, 2, 3 and 9 <br />1, 2, 3 and 9 <br />For the State Department o` He�a�"r, Services - <br />Radiologic Health Branch fff <br />P.O. Box 942732 <br />Sacramento, CA 94234-732C .' <br />3 <br />