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<br />RADIOACTIVE MATERIAL LICENSE
<br />Department of Health Services
<br />Page 2 of 4 pages
<br />License Number: 1368-39
<br />Amendment Number: 27
<br />Group 2 Diagnostic studies involving imaging including the use of Xenon -127 and/or Xenon -133 gas.
<br />Group 3 Reagent kits utilizing bulk technetium prepared by a radiopharmacy for preparation of
<br />radiopharmaceuticals listed in Group 2.
<br />Group 4 Internal therapy and palliative treatment not usually requiring hospitalization.
<br />B. Group 6 Brachytherapy and Ophthalmic treatments utilizing sealed or solid sources manufactured, labeled,
<br />packaged, and distributed in accordance with a specific license issued pursuant to Title 10, Code of
<br />Federal Regulations, Part 32.74, or a specific license issued by an Agreement State pursuant to
<br />equivalent state regulations (except for sources manufactured prior to August 16, 1974).
<br />C. Group 9 Marker and calibration sources.
<br />LICENSE CONDITIONS
<br />10. Radioactive material shall be used only at the following location:
<br />(a) 975 South Fairmont Avenue, Lodi, CA
<br />11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any one time
<br />as specified in items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in
<br />accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual
<br />cost -of -living adjustment pursuant to Section 100425 of the California Health and Safety Code.
<br />12. The individuals named below are authorized the specific uses of radioactive material described in Items 6, 7, 8, and 9
<br />of this license as follows:
<br />(a)
<br />Roger P. Vincent, M.D.
<br />Groups
<br />1, 2, 3, 4, 6 (Strontium -90 only) and 9
<br />(b)
<br />Dennis D. Jacobsen, M.D.
<br />Groups
<br />1, 2, 3, 4, 6 (Strontium -90 only) and 9
<br />(c)
<br />Henry Y. P. Wong, M.D.
<br />Groups
<br />6 and 9
<br />(d)
<br />Frank M. Hartwick, M.D.
<br />Groups
<br />1, 2, 3, 4 (I-131 only) and 9
<br />(e)
<br />R. Brandon Rankin, III, M.D.
<br />Groups
<br />1, 2, 3, 4 (I-131 only), 6 (Strontium -90 only) and 9
<br />(f)
<br />Patricia K. Richardson, M.D.
<br />Groups
<br />1, 2, 3 and 9
<br />(g)
<br />Grant W. Rogero, M.D.
<br />Groups
<br />1, 2, 3 and 9
<br />(h)
<br />Edward C. Greenleaf, M.D.
<br />Groups
<br />6 and 9
<br />(i)
<br />Harvey A. Gilbert, M.D.
<br />Groups
<br />4 and 6
<br />0)
<br />Douglas McGirr, M.D.
<br />Groups
<br />1, 2, 3 and 9
<br />(k)
<br />Michael R. Rigdon, M.D.
<br />Groups
<br />1, 2, 3 and 9
<br />(1)
<br />Roger S. Eng, Jr., M.D.
<br />Groups
<br />1, 2, 3, 4 and 9
<br />(m)
<br />Majid Majidian, M.D.
<br />Groups
<br />1, 2, 3 and 9
<br />13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material
<br />described in Items 6, 7, 8 and 9 of this license in accordance with the statements, representations, and procedures
<br />contained in the documents listed below. The Department's regulations shall govern unless the statements,
<br />representations, and procedures in the licensee's application and correspondence are more restrictive than the
<br />regulations.
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