Laserfiche WebLink
SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E. Hazelton Ave • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Jasjit Kang, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - PE 4110 - BODYART PRACTITIONER REGISTRATION <br />Permit ID # PT0028768 for Record ID # PR0547850 <br />Valid From 7/13/2022 To 6/30/2023 <br />PERMTTS TO OPERATE aze NOT TRANSFERABLE <br />and maybe SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: PINA, GABRIEL <br />DBA: PURE FORM TATTOO &GALLERY <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: PURE FORM TATTOO &GALLERY (PINA, GABRIEL) Facility <br />ID FA0027272 <br />213 W YOSEMITE AVE Account to AR0052418 <br />MANTECA CA 95336 Issued 7/21/2022 <br />Billing <br />Address: ATTN : PINA, GABRIEL <br />PURE FORM TATTOO &GALLERY <br />1425 HOLM AVE <br />MODESTO CA 95351 <br />7027.Mt End of Report <br />