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2011_0711_packet
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2011_0711_packet
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2/15/2012 1:34:42 PM
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12/21/2011 3:25:05 PM
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.................... .................... <br />WA I in pq <br />It of Ill <br />61 <br />Finance Department, License Division <br />2660 Cl*"*c Center Drive, Roseville, MN 55'113 <br />(651) 792-7036 <br />Massage, Therapy Establishment License Application <br />- an jenp r*J <br />Business Name JF, 0 CC, ........ <br />"WRANNNOW- I <br />Legal Name .. 1.1� ................. <br />------- ----- <br />Address .... ..... .. .... .. .. .. . . . ... ... .. <br />Drivers License Number, - <br />Date of Birth' <br />i hereby apply for the folloiwing license(s) for the term of'one year, beginning July 1,'24pt &I and ending <br />june 31,2P—Ij—ZwP, 'in the City of Rosevill County of Ramsey, and State of Minnesota. <br />Massage Therapy Establishment <br />$300.001 <br />$150,00 Background Check <br />(new license oinly) <br />9MMIr <br />OIG......................... <br />0, <br />If completed license should be mailed somewhere other, than the busioness address, please advise, <br />
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