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OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT <br />LaB� lk, FACILITIES DEVELOPMENT DIVISION <br />7 <br />TEST TECHNICIANS (Continued) <br />Provide Following Information for Each Test Technician Employed by the Agency (Attach <br />additional sheets if needed) <br />*To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required <br />Test Technician's Certification/ Certification/ Certification/ <br />Name License Type Licensing Agency License Number Expiration Date* Comments <br />Test Technicians wit17 expired license shaft not be permitted to perform Tests. <br />Access to Safe. Quality Healthcare Environments that Meet CaMmia's Diverse antl Dvnamlc Needs <br />OSH PD <br />STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY <br />OSH-FD-OPAA-100 (6/24/2016) <br />3/28/2017 OPAA-0010-16 <br />Page 11 of 19 <br />