Certificate of Veterinary Inspection · issued 2022-02-07
35-245593
RIDGLAN FARMS, INC. → IIT RESEARCH INSTITUTE · 4 dogs
Consignor (shipper)
RIDGLAN FARMS, INC.
10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517
Consignee (buyer)
STATE STREET DOCK 10 WEST 35TH STREET CHICAGO, IL 60616
Carrier
Not stated on the certificate.
Issuing Veterinarian
Richard J. Van Domelen, D.V.M.
P.O. BOX 318, MT. HOREB, WI 53572
Remarks / additional certifications
Owner/Agent mailing address: P.O. Box 318, Mt. Horeb, WI 53572. Email: ridglan@mhtc.net. Permit Number: 191836-WEB6658. Not returning to WI.
Animals listed on this shipment (4)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| PFQ-1 | Beagle | F | 5 mos; Rabies Vaccination Date: 02/07/22; Rabies Exp. Date: 02/07/23; Rabies Product: Nobivac 1 Rabies; Rabies Tag: N/A; Other Vaccinations: Canine 1-DAPPv; Date Vaccinated: 01/07/22; Other Vaccine Producer: Nobivac | 523628 | ||
| QWQ-1 | Beagle | |||||
| LOR-1 | Beagle | M | ||||
| SSR-1 | Beagle | Rows 2-4 appear to have checkmarks indicating same vaccination info as row 1 | Rows 2-4 appear to have checkmarks indicating same vaccination info as row 1 |
The CVI form lists each dog individually. Per-animal vaccination and treatment history is on the source PDF.
Primary source
This certificate was published by Wisconsin DATCP and is hosted on cvicentral.com. Click through to see the original PDF with all vaccination dates, treatment records, and any handwritten notes.
Extraction provenance
shrine_id BUNDLE-e2363096-1 · doc_class PaperCvi