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0 'di 0 <br />Nias,sagewe Therapy Establishment License, Application <br />NWIMM�-N <br />VITMUMMMON <br />FOT� � <br />Email Address <br />M <br />Q" <br />0 <br />Drivers License, Number cz 11 %Mi 4 46mor 9i low MI <br />y' for I <br />I hereby app) the following liciense(s) for the term of'one year, beginning July I 2ea I( , and ending <br />IbO 13, , in the City of Roseville, Couinty of Ramsey,, and Sit,ate of Minnesota, <br />June 3 1, — I I I <br />Massiage Therapy Establishment <br /><300.0 <br />P <br />$ 2 a <br />150.00 ackgroun I Check <br />(,newi license only) <br />A I "M <br />M111 <br />Siognature. <br />(070 <br />lf comp let ed license should be mal"led somewhere other than Dkw6usinessi address, please advise. <br />