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Certificate of Veterinary Inspection · issued 2025-09-17

35-265261

RIDGLAN FARMS, INC.UNIVERSITY OF ILLINOIS · 6 dogs

Open source PDF ↗

Consignor (shipper)

RIDGLAN FARMS, INC.

10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517

Phone
608-437-8670

Consignee (buyer)

UNIVERSITY OF ILLINOIS

2001 S. LINCOLN URBANA, IL 61802

State
IL
Shipped
2025-09-17
Inspected
2025-09-17
Issued
2025-09-17
Purpose
Species
Dog

Carrier

Not stated on the certificate.

Issuing Veterinarian

Richard J. Van Domelen, D.V.M.

P.O. BOX 318 MT. HOREB, WI 53572

Phone
608-437-8670
State license
404991
USDA accreditation
033491

Health declarations

Rabies
Vaccinated - CBQ-2 vaccinated 10/11/2024, expires 10/11/2025, Nobivac 3-Rabies, serial 688214
Other declarations
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.

Vaccinations (4)

NameManufacturer / ProductLotAdministeredExpiresApplies to
RabiesNobivac / Nobivac 3-Rabies6882142024-10-112025-10-11specific
CANINE 1-DAPPvNobivac / Nobivac2025-09-12specific
Rabiesspecific
Other Vaccinationsspecific

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)

IDBreedSexAge / DOBColorMicrochip / tattooOther
CBQ-2BeagleFADULTADULT
CEC-3BeagleFADULTADULT
CSQ-2BeagleFADULTADULT
CUQ-2BeagleFADULTADULT
OWW-2BeagleFADULTADULT
TKI-2BeagleFADULTADULT

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.

Open CVI 35-265261
Extraction provenance
Source modeltier2b · claude-sonnet-4-6 · prompt tier2b.dittoaware
Extracted2026-05-27 00:37:50
Tokensin 3395 · out 2543 · cost $0.0483
Overall confidence0.82 · cross-tier agreement 1.00
Model notes1. Ditto/vertical line rule applied: Row 1 (CBQ-2) has explicit Sex=F and Age=ADULT entries; a vertical line runs through rows 2-6 for Sex and Age columns, so all six animals inherit F and ADULT. 2. Breed 'BE' expanded to 'Beagle' for all rows. 3. Row 6 (TKI-2) has checkmarks (tick marks) in Rabies Vaccination Date, Rabies Vaccination Exp. Date, Product & Vaccine Producer, Serial Number, Rabies Tag Number, Other Vaccinations, Date Vaccinated, and Product & Vaccine Producer columns — indicating vaccinations were given but specific details are not legibly written (likely same as CBQ-2 or marked as applicable). These are captured as separate vaccination entries with null details. 4. Rows 2-5 (CEC-3, CSQ-2, CUQ-2, OWW-2) appear blank in vaccination columns with no checkmarks — vaccination details not filled. 5. The owner mailing address differs from origin address: P.O. Box 318 Mt. Horeb, WI 53572 vs 10489 W. Blue Mounds Road, Blue Mounds, WI 53517 — both belong to Ridglan Farms, Inc. 6. Certificate number 35-265261 taken from top right. 7. Permit number IPOIZ7LR noted in remarks. 8. Only one page in document.

shrine_id 1279184 · doc_class PaperCvi