State Regulatory Board · Submission Record
Biennial license renewal submission. All 30 required CE hours completed. Facility address updated to reflect relocation completed February 2024. New facility inspection certificate attached.
This narrative was submitted directly by the licensee in a structured format. No reconstruction by staff was required.
| Document Label | Filename | Logged |
|---|---|---|
| Renewal Application | renewal_application.pdf | 2024-04-03 11:00 |
| CE Certificates | ce_completion_certificates.pdf | 2024-04-03 11:00 |
| Inspection Certificate | facility_inspection_cert.pdf | 2024-04-03 11:00 |
This record was generated from structured intake fields submitted through Civic Tide Licensing. No manual reconstruction was required. All documents are labeled as submitted.
Civic Tide Licensing · State Regulatory Board · SUB-2024-0037 · Confidential