ML20212P400
| ML20212P400 | |
| Person / Time | |
|---|---|
| Site: | 07002259 |
| Issue date: | 05/16/1986 |
| From: | Lintjer G COPLEY MEMORIAL HOSP., AURORA, IL |
| To: | NRC OFFICE OF NUCLEAR MATERIAL SAFETY & SAFEGUARDS (NMSS) |
| Shared Package | |
| ML20212P357 | List: |
| References | |
| 26990, NUDOCS 8701300661 | |
| Download: ML20212P400 (2) | |
Text
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(.RLGORY W. L lNTJER
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Division of Fuel Cycle and Materials Safety U.S. Nuclear Regulatory Comission y
Washington, D.C.
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w" RE: Renewal of Special Nuclear Material License - Reference # 70-2259 Gentlemen:
Copley Manorial Hospital is in receipt of an announcement notifying us that the nuclear material license which we hold (SrM-1634) expires on June 30, 1986.
The purpose of this letter is to request renewal of our license. We will continue to follow and abide by all of the protocols submitted in the original application. 'Ihe Physician that wishes to continue to participate is:
1 Name:
Abbas A. Khawaja, M.D.
Office Address:
157 South Lincoln, Aurora, Illinois 60505 Telephone Ntaber:
(312) 897-5330 Hcme (312) 466-4080 State of License: Illinois Specialty Board Certification: Internal Medicine, June 1972.
Training: Two years fellowship in Adult Cardiology at Cook County Hospital, Chicago, Illinois (July 1, 1972 -
June, 1974)
Position with Applicant: Cardiologist on staff at copley Hospital Previous clinical experience with pacemakers.
Duration of pacemaker experience:
15 years.
Copley Hospital requests authorization for the following numbers and types of pacemakers:
Total Cordis Nuclear Omni Stanicor Model (184A 10 Coromatic Model C-10,177 Jjm g y
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Medtronic Model 9000 Isotopic pulse generator 4
I trust that this information is adequate for review of our license renewal, but should you have additional questions, please do not hesitate to call.
Respectfully, COPLEY MEMRIAL HOSPITAL Gre!
gory. Lintjer President GWL:dek i
cc: Julius Newnan, M.D.
Vice President, Medical Affairs Abbas Khawaja, M.D.
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