OF CERTIFIc4QopennsylvaniaDEPARTMENT OF HEALTH

JOSHUA R CLARK

Pursuant to the Emergency Medical Services Act, Act of Jety 2.

as set forth in Section 1003 of the rules and regulations tne Certification to the above individual.

TYPE OF CERTIFICATE:CERTIFICATION NUMBER:

EXPIRES ON:

PL. 164. No. 45, as amended, 35 P.S. Section 6921 et seq., andDepartment of Health hereby issues this Notice of

EMT

118968

04/01/2013

This CERTIFICATION shall expire on the above date, unless for good cause is suspended or revoked sooner.

Joesph W. Schmider, Director

Bureau of Emergency Medical Services

Q.

A. Everette JamesActing Secretary of Health