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State of Califomia-Health and Welfare Agency
<br />RADIOACTIVE MATERIAL LICENSE
<br />Supplementary Sheet
<br />9. Authorized Use
<br />To be used for nuclear medicine procedures as specified in the groups below.
<br />Department of Health Services
<br />Page 2 of 6 pages
<br />License Number: 1294-39
<br />Amendment Number: 54
<br />A. Group 1 Diagnostic studies involving measurement of uptake, dilution, or excretion but not involving
<br />imaging.
<br />B. Group 2 Diagnostic studies involving imaging including the use of Xenon 127 and/or Xenon 133 gas.
<br />C. Group 3 Reagent kits for preparation of radiopharmacuticals listed in Group 2.
<br />D. Group 4 Internal therapy not usually requiring hospitalization.
<br />E. Group 5 Internal therapy requiring hospitalization for purposes of radiation safety.
<br />F. Group 9 Marker and calibration sources.
<br />LICENSE CONDITIONS
<br />10. Radioactive material shall be used only at the following locations:
<br />(a) 500 West Hospital Road, French Camp, CA
<br />11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any
<br />one time as specified in Item 8 of this license. The annual fee for this license is required by and computed
<br />in accordance with Sections 30230-30232 of the California Radiation Control Regulations and is also subject
<br />to an annual cost -of -living adjustment pursuant to Section 113 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,
<br />8 and 9 of this license as follows:
<br />(a) Douglas McGirr, M.D.
<br />(b) Michael R. Rigdon, M.D.
<br />(c) Marina S. Soosaipillai, M.D.
<br />(d) Wyman K. Yee, M.D.
<br />(e) Ramesh N. Dharawat, M.D.
<br />(f) Roger P. Vincent, M.D.
<br />(g) Dennis D. Jacobson, M.D.
<br />(h) Frank M. Hartwich, M.D.
<br />(i) R. Branden Rankin, III, M.D.
<br />0) Patricia K. Richardson, M.D.
<br />(k) Grant W. Rogero, M.D.
<br />Groups 1, 2, 3, and 9.
<br />Groups 1, 2, 3, and 9.
<br />Groups 1, 2, 3, and 9.
<br />Groups 1, 2, 3, 4, 5, and 9.
<br />Groups 2 (Cardiology studies only), and 9
<br />Groups 1, 2, 3, 4, 5, and 9
<br />Groups 1, 2, 3, 4, 5, and 9
<br />Groups 1, 2, 3, (4 & 5, I-131 only), and 9
<br />Groups 1, 2, 3, (4 & 5, I-131 only), and 9
<br />Groups 1, 2, 3, and 9
<br />Groups 1, 2, 3, and 9
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