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=i OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT <br />rht�TV ' FACILITIES DEVELOPMENT DIVISION <br />7 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/ Expiration Date* Comments <br />Name License Type Licensing Agency License Number <br />Test Technicians with expired license shall not be permitted to perfonn Tests. <br />OSNPD <br />-Access to Safe, Quality Healthcare Environments that Meet California's Diverse and Dynamic Needs <br />STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY 1 1 " <br />OSH-FD-OPAA-100 (03/01 /2018) Page 11 of 19 <br />5l6/2019 OPAA-0042-16 <br />