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Get MA Laser Registration Application 2018-2024

N Street, Charlestown, MA 02129 RADIATION CONTROL PROGRAM Phone: (617)-242-3035 Fax: (617) 242-3457 ï‚£ RENEWAL www.mass.gov/dph/rcp Email: RadiationControl@state.ma.us ï‚£ DEMONSTRATION If Applicable, Laser Registration Number: MAILING ADDRESS LASER LOCATION (if different than Mailing Address) (NOTE: Submit separate application for each additional laser location) Legal Name of Business / Facility / Individual: Physical Address: Mailing Address: City, State & Zip: City, State & Zip:.

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