[Histonet] odefreitasIHCRG Membership Application Form

[Patsy Ruegg]

verify NSh membership please
 
Patsy Ruegg, HT(ASCP)QIHC
IHCtech, LLC
Fitzsimmons BioScience Park
12635 Montview Blvd. Suite 216
Aurora, CO 80010
P-720-859-4060
F-720-859-4110
wk email pruegg <@t> ihctech.net
web site www.ihctech.net <http://www.ihctech.net/> 
 

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From: webmaster <@t> neo.agsci.colostate.edu
[mailto:webmaster <@t> neo.agsci.colostate.edu] 
Sent: Thursday, January 12, 2006 10:54 AM
To: pruegg <@t> ihctech.net
Subject: IHCRG Membership Application Form


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Last_Name: DeFreitas
First_Name: Otis
NSH_Member: Yes
Employer: our lady of lourdes & Virtua
Address: 1600 Haddon avenue
City: Camden
State: NJ
Zip: 08103
Province: 
Country: 
Phone: 856-757-3584
Ext: 
Fax: 
Email: redemptionsharps <@t> yahoo.com
Surgical_Pathology: Yes
Hematopathology: 
Orthopedic: 
Veterinary: 
Immunology: 
Plastics: 
Research: 
Paraffin: Yes
Frozen: Yes
Cytospins: Yes
Smears_Touch_Preps: 
Plastics_sample: 
Sample_Other: 
PAP: 
APAAP: 
ABC_HRP: Yes
ABC_AP: Yes
SA_HRP: Yes
SA_AP: 
IF: 
IHC_Other: 
ISH: Yes
Gels: 
PCR: 
Mol_Other: 
Automated_IHC: Yes
Company: Dako
IHC_Qualification: No
Date_Taken_Exam: 
Like_To_Take_Exam: Yes
Expected_Date: 7/2006
Need_Tissues: No
Tissue_Needed: 
Need_Reagents: No
Reagents_Needed: 
Can_Provide_Tissues: No
Tissues_Provided: 
Can_Provide_Reagents: No
Reagents_Provided: 
Form: Submit
Remote Name: 198.245.165.200
HTTP User Agent: Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 4.0)



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