Certificate of Veterinary Inspection · issued 2025-09-17
35-265261
RIDGLAN FARMS, INC. → UNIVERSITY OF ILLINOIS · 6 dogs
Consignor (shipper)
RIDGLAN FARMS, INC.
10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517
Carrier
Not stated on the certificate.
Issuing Veterinarian
Richard J. Van Domelen, D.V.M.
P.O. BOX 318 MT. HOREB, WI 53572
Health declarations
Vaccinations (4)
| Name | Manufacturer / Product | Lot | Administered | Expires | Applies to |
|---|---|---|---|---|---|
| Rabies | Nobivac / Nobivac 3-Rabies | 688214 | 2024-10-11 | 2025-10-11 | specific |
| CANINE 1-DAPPv | Nobivac / Nobivac | 2025-09-12 | specific | ||
| Rabies | specific | ||||
| Other Vaccinations | specific |
Remarks / additional certifications
Owner/Agent: Pamela J. Clurben. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572. Permit Number: IPOIZ7LR. Not returning to WI.
Veterinarian certifies animals are not showing any signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and test results are as indicated on certificate.
Emails on form: ridglan@mhtc.net
Animals listed on this shipment (6)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| CBQ-2 | Beagle | F | ADULT | ADULT | ||
| CEC-3 | Beagle | F | ADULT | ADULT | ||
| CSQ-2 | Beagle | F | ADULT | ADULT | ||
| CUQ-2 | Beagle | F | ADULT | ADULT | ||
| OWW-2 | Beagle | F | ADULT | ADULT | ||
| TKI-2 | Beagle | F | ADULT | ADULT |
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 1279184 · doc_class PaperCvi