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The I-70 Scout & Eastern Colorado News

Category: Health & Food Recalls

  • Construction Begins on Additional State Hospital Beds

    Construction Begins on Additional State Hospital Beds

    PUEBLO — The Colorado Mental Health Institute at Pueblo (CMHIP) began construction last month on a unit that will add 24 beds to the state’s forensic hospital. Adding beds to the state hospital in Pueblo is part of a coordinated strategy to ensure patients are able to access competency services in a timely manner.

    The 24 beds will be within CMHIP’s High Security Forensic Institute building and are expected to open in November 2020. The project budget is $7 million.

    The 24 beds are part of a total 128 beds being added this summer through December 2021:

    On June 3, the Forensic Services Jail-Based Evaluation and Restoration team opened a second location for jail-based competency evaluation and restoration services, adding 18 beds at the Boulder County Jail. ($2.2 million)

    We are in the process of construction and modifications at CMHIP that will lead to a medium-security restoration to competency unit, increasing CMHIP’s capacity by 42 beds with an estimated opening in December 2019. ($844,000)

    The Colorado Mental Health Institute at Fort Logan’s F2 & F3 Cottages will be renovated to add 44 beds, increasing the hospital’s capacity by almost 50 percent with an estimated completion date of December 2021. The additional beds will be dedicated to restoration, while the hospital’s current 94 beds will remain dedicated to civil patients. ($17.8 million)

    In March, the Department reached an agreement that resolved an eight-year-old federal lawsuit over wait times for court-ordered competency services by expanding community-based services, providing treatment for people in jail waiting for services, and expediting inpatient services for Coloradans experiencing a serious mental health episode.

    “These beds are important to expand the state’s capacity to serve people who are awaiting trial and need inpatient competency services,” said Robert Werthwein, director of the Department’s Office of Behavioral Health, which oversees the mental health institutes. “Adding beds is part of a larger solution that includes an expansion of community-based services in an effort to better serve people in our state.”

    The Department is also working through the Behavioral Health Task Force and the Long Term Competency subcommittee, which was created by Governor Polis, to develop a comprehensive plan for individuals in the criminal justice system who have been found incompetent to proceed, and on future solutions to increase community interventions as a means to reduce demand on forensic solutions to mental health.

     

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  • Autism rates among black, Hispanic children increasing

    Autism rates among black, Hispanic children increasing

    Boulder — Autism rates among racial minorities in the United States have increased by double digits in recent years, with black rates now exceeding those of whites in most states and Hispanic rates growing faster than any other group, according to new University of Colorado Boulder research.

    The study, published this month in the Journal of Autism and Developmental Disorders, also found that prevalence of autism among white youth is ticking up again, after flattening in the mid-2000s.

    While some of the increase is due to more awareness and greater detection of the disorder among minority populations, other environmental factors are likely at play, the authors conclude.

    “We found that rates among blacks and Hispanics are not only catching up to those of whites — which have historically been higher — but surpassing them,” said lead author Cynthia Nevison, an atmospheric research scientist with the Institute of Arctic and Alpine Research. “These results suggest that additional factors beyond just catch-up may be involved.”

    For the study, Nevison teamed up with co-author Walter Zahorodny, an autism researcher and associate professor of pediatrics at Rutgers New Jersey Medical School, to analyze the most recent data available from the Individuals with Disabilities Education Act (IDEA) and the Autism and Developmental Disabilities Monitoring (ADDM) Network.

    IDEA tracks prevalence, including information on race, among 3-to-5-year-olds across all 50 states annually. ADDM tracks prevalence among 8-year-olds in 11 states every two years.

    The new study found that between birth year 2007 and 2013, autism rates among Hispanics age 3-5 rose 73%, while rates among blacks that age rose 44% and rates among whites rose 25%. 

    In 30 states, prevalence among blacks was higher than among whites by 2012.

    In states with “high prevalence,” 1 in 79 white children, 1 in 68 black children and 1 in 83 Hispanic children born in 2013 have been diagnosed with autism by age 3-5.

    Other states like Colorado fell in a “low-prevalence” category, but the authors cautioned that differences between states likely reflect differences in how well cases are reported by age 3-5. They also said the real prevalence is substantially higher, as many children are not diagnosed until later in life.

    “There is no doubt that autism prevalence has increased significantly over the past 10 to 20 years, and based on what we have seen from this larger, more recent dataset it will continue to increase among all race and ethnicity groups in the coming years,” said Zahorodny.

    In 2018, the Centers for Disease Control reported that about 1 in 59 children of all races have been diagnosed with autism and that rates had risen 15 percent overall from the previous two year period, largely due to better outreach and diagnosis among historically underdiagnosed minority populations. The new study challenges that explanation.

    “Our data contradict the assertion that these increases are mainly due to better awareness among minority children,” said Zahorodny. “If the minority rates are exceeding the white rates that implies some difference in risk factor, either greater exposure to something in the environment or another trigger. 

    Established risk factors associated with autism include advanced parental age, challenges to the immune system during pregnancy, genetic mutations, premature birth and being a twin or multiple.

    The authors said that, based on current research, they cannot pinpoint what other environmental exposures might be factoring into the increases in autism. But they would like to see more research done in the field.

    “I’d like to see our public health agencies acknowledge the steep increase in autism among American children over the last 40 years and explore what environmental factors might be making minority children more vulnerable,” said Nevison.

     

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  • No new cases of sudden and severe lung illness associated with vaping

    No new cases of sudden and severe lung illness associated with vaping

    DENVER: The Colorado Department of Public Health and Environment will provide updates on sudden and severe lung illness in Colorado if or when there is new information. 

    Over the weekend, the number of confirmed cases held steady. Colorado has one confirmed case of sudden and severe lung illness tied to vaping. 

    “Confirmed case” means it meets all the criteria for the definition being used nationally and that exposure to vaping products was most likely the cause of the illness based on the review. The department is investigating all cases reported to us to determine whether they meet this definition. 

    All affected people reported using vaping liquids or oils that contained nicotine, marijuana, CBD, synthetic marijuana, or a combination of these. 

    Colorado has an unusually high rate of teen and young adult nicotine vaping. Colorado clinicians, school-based health centers, campus health centers, parents, and people who vape should be aware that this outbreak is occurring and be on the lookout for symptoms. 

    Symptoms include:

    • Shortness of breath or trouble breathing 
    • Chest pain
    • Cough
    • Fatigue
    • Possible fever

    People who vape and currently have a lung illness or may have had one since June 1, 2019 should contact their doctor or local health department. 

    Vaping products contain more than just harmless water vapor. The agents causing this illness could possibly be pesticide contamination, residual solvent contamination, additives with unknown inhalation effects, or heavy metals contamination inhaled from vaping products. 

    Health care providers, school based health centers, and campus health centers should:

    • Screen all youth, parents, and caregivers for e-cigarette use and exposure.
    • Counsel children and adolescents about the harms of e-cigarette use and clearly communicate the importance of never using e-cigarettes or other nicotine products.
    • Report suspected cases to CDPHE’s Disease Reporting Line: 303-692-2700 or 303-370-9395 (after hours). This includes potential cases who presented since June 1, 2019. CDPHE personnel will conduct a medical record review and contact the patients to administer a thorough investigation questionnaire.

    Parents should:

    • Talk with your kids about the risks of using e-cigarettes. Get the facts for your conversations at www.tobaccofreeco.org/know-the-facts.
    • Set a smoke- and vapor-free rule for your home and car.

    Youth and young adults who vape should: 

    • Be aware that this illness is occurring and be on the lookout for symptoms. 
    • Learn more about free resources available to help you quit all tobacco products at coquitline.org or 1800-QUITNOW.

     

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  • Update on sudden and severe lung illness associated with vaping

    Update on sudden and severe lung illness associated with vaping

    DENVER: The Colorado Department of Public Health and Environment will provide updates on the numbers of confirmed and suspected cases of sudden and severe lung illness  in Colorado associated with vaping every weekday, midday, until further notice. 

    Colorado has one confirmed case and three suspected cases of sudden and severe lung illness tied to vaping. Staff members are actively investigating these cases. All the cases involve patients living in the  Front Range area. The confirmed case is a young adult , and all suspected cases are adults.  

    “Confirmed case” means it meets all the criteria for the definition being used nationally and that exposure to vaping products was most likely the cause of the illness based on the review.

    All cases reported using vaping liquids or oils that contained either nicotine, marijuana, CBD, synthetic marijuana, or a combination of these. 

    Colorado has an unusually high rate of teen and young adult nicotine vaping. Colorado clinicians, school-based health centers, campus health centers, parents, and people who vape should be aware that this outbreak is occurring and be on the lookout for symptoms. 

    Symptoms include:

    • Shortness of breath or trouble breathing 
    • Chest pain
    • Cough
    • Fatigue
    • Possible fever

    People who vape and currently have a lung illness or may have had one since June 1, 2019 should contact their doctor or local health department. 

    Vaping products contain more than just harmless water vapor. The agents causing this illness could possibly be pesticide contamination, residual solvent contamination, additives with unknown inhalation effects, or heavy metals contamination inhaled from vaping products. 

    Health care providers, school based health centers, and campus health centers should:

    • Screen all youth, parents, and caregivers for e-cigarette use and exposure.
    • Counsel children and adolescents about the harms of e-cigarette use and clearly communicate the importance of never using e-cigarettes or other nicotine products.
    • Report suspected cases to CDPHE’s Disease Reporting Line: 303-692-2700 or 303-370-9395 (after hours). This includes potential cases who presented since June 1, 2019. CDPHE personnel will conduct a medical record review and contact the patients to administer a thorough investigation questionnaire.

    Parents should:

    • Talk with your kids about the risks of using e-cigarettes. Get the facts for your conversations at www.tobaccofreeco.org/know-the-facts.
    • Set a smoke- and vapor-free rule for your home and car.

    Youth and young adults who vape should: 

    • Be aware that this illness is occurring and be on the lookout for symptoms. 
    • Learn more about free resources available to help you quit all tobacco products at coquitline.org or 1800-QUITNOW.

     

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  • Public Health and Safety Advisory

    Public Health and Safety Advisory

    August 16, 2019 – The Colorado Department of Revenue (DOR), in conjunction with the Colorado Department of Public Health and Environment (CDPHE), is issuing a health and safety advisory due to the identification of potentially unsafe levels of microbial contamination on medical marijuana and retail marijuana produced by Herbal Wellness LLC. CDPHE and DOR deem it a threat to public health and safety when marijuana is found to have levels of microbial contaminants above the acceptable limits established in MED Rule M 712 and R 712. The DOR has also identified harvest batches of medical marijuana and retail marijuana produced by Herbal Wellness LLC that were not tested in accordance with MED Rules M 1501 and R 1501. Consumers who have these affected products in their possession should return them to the retail store from which they were purchased so they can be properly disposed of. All affected marijuana has a label affixed to the container that, at a minimum, indicates the license number of the medical or retail marijuana business that cultivated the marijuana as well as the Harvest Batch number assigned to the marijuana. Consumers should check the label of their medical marijuana or retail marijuana for the following License Numbers and Harvest Batch Numbers. Any inconsistencies in the Harvest Batch Number formats are a result of the licensee labeling procedures. Look for this specific language on the label of your marijuana product. Medical Marijuana Cultivation Facility License 403-01050 and/or Medical Marijuana Center License 402-00698

    Contaminated Harvest Batch numbers:

    • Lemon Train (07/09/19)

    • King Jack (07/01/19)

    • Chernobyl (07/01/19)

    • Sunburn (6/28/19)

    • Jesus OG (6/28/19)

    • Bruce Banner (5/23/19)

    • Wedding Cake (5/23/19)

    • King Jack (5/21/19)

    • Cookies & Dream (5/21/19) •

    Sour Diesel (5/13/19)

    • Black Medallion (5/13/19)

    • Lemon Train (05/06/19)

    • Jesus OG (3/18/19)

    • The Animal Untested Harvest Batch numbers:

    • Wedding Cake (05/06/19)

    • Sour Diesel (04/17/19)

    • Pandora’s Box (3/18/19)

    • Black Medallion 3/5/19

    • Deep Purple 2/5/19

    • Qleaner 2/5/19

    • Gorilla Glue #4 2/5/19

    • Lemon Train 2/5/19

    • Commerce City Kush 1/18/19

    • Cotton Candy X Sour Diesel 1/2/19

    • Pineapple Express 12/31/18

    • Chocolopez 12/31/18

    Contaminated Harvest Batch numbers:

    • Chocolopez (7/16/19)

    • Bruce Banner (7/16/19)

    • Lemon Train (7/15/19)

    • Chernobyl (07/02/19)

    • Jesus OG (07/01/19)

    • King Jack (07/01/19)

    • Chernobyl (07/01/19)

    • Wedding Cake (06/28/19)

    • Lemon Train (06/27/19)

    • Commerce City Kush (06/26/19)

    • King Jack (6/26/19)

    • Chernobyl (6/26/19)

    • Jesus OG (06/26/19)

    • Pineapple Express (6/25/19)

    • Jack The Ripper (06/25/19)

    • King Jack (6/25/19)

    • Lemon Train (6/4/19)

    • Lemon Train (5/30/19)

    • Biesel (5/24/19)

    • Chernobyl (5/24/19)

    • King Jack (5/23/19)

    • Cookies & Dream (5/21/19)

    • Lemon Train (5/21/19)

    • Dairy Queen (5/20/19)

    • Black Medallion (5/13/19)

    • Wedding Cake (5/14/19)

    • Commerce City Kush (04/17/19)

    • Chocolopez (04/03/19)

    • Tribal Delight (3/27/19)

    • King Jack 2/26/19

    Untested Harvest Batch numbers:

    • Wedding Cake (6/5/19)

    • Blueberry Snow x Brutha Hood (5/24/19)

    • Jesus OG (5/22/19)

    • Sour Diesel (5/14/19)

    • Jack Skellington (05/06/19)

    • Jacks Cleaner (05/06/19)

    • Sweetest Peach (05/06/19)

    • Jack Skellington (04/30/19)

    • Sunburn (04/29/19)

    • Jack The Ripper (04/29/19)

    • Lemon Train (04/29/19)

    • Boss Hog (04/18/19)

    • Cinderella 99 (04/18/19)

    • Chem Thai (04/18/19)

    • Jack The Ripper (04/18/19)

    • Sunburn (04/18/19)

    • Tangberry Blue (04/18/19)

    • Boss Hog (4/17/19)

    • Jack The Ripper (04/12/19)

    • Ripped Bubba (04/04/19)

    • Red Headed Stranger 3/5/19

    • Lemon Train 2/26/19

    • Agent Orange 2/26/19

    • Commerce City Kush 2/26/19

    • Jack the Ripper 2/26/19

    • Sour Diesel 1/16/19

    • Red Rocket 1/15/19

    • Sour Diesel 1/15/19

    • Gorilla Glue 1/15/19

    • Pineapple Express 1/15/19

    • Jack the Ripper #10 1/10/19

    • Pre 98 Bubba 1/10/19

    • Grape Inferno #1 1/10/19

    • Jesus OG 1/9/19

    • Agent Orange 1/9/19

    • Durban Poison 1/9/19

    • Grape Inferno 1/9/19

    • Pre 98 Bubba

    • Jack the Ripper 1/9/19

    • Chernobyl 1/9/19

    • Brightberry Cookies 1/8/19

    • Sunburn 1/3/19

    • Cotton Candy X Sour Diesel 1/3/19
     

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  • Trump signs bill allowing veterans to seek care outside broken VA system

    Trump signs bill allowing veterans to seek care outside broken VA system

    WASHINGTON, D.C.- President Trump signed legislation Wednesday that will dramatically expand a program at the Department of Veterans Affairs that lets patients seek care from private doctors if they want to bypass the troubled VA system.

    The Veterans Choice Improvement Act removes barriers that Congress placed around the original “choice” initiative and eliminates an expiration date that would have shuttered the program in August.

    Lawmakers created the choice program in 2014 after a massive scandal involving wait time cover-ups at more than 100 VA facilities around the country. It was initially structured as a two-year pilot program that limited when and where veterans could choose to see private doctors. Patients could only use the choice program if they lived more than 40 miles from the nearest VA hospital or if they could not get an appointment from their local VA facility within 30 days.

    The choice program has proven controversial since its inception three years ago. Critics have questioned whether increasing veterans’ reliance on private doctors might move the VA toward privatization, while proponents of such efforts have accused the VA of resisting steps to implement the program in order to protect the status quo.

    Walter Reed Medical Center
    Walter Reed Medical Center. AP

    Some veterans advocates, such as Concerned Veterans for America, praised the administration’s temporary push to extend choice but encouraged lawmakers to continue searching for solutions to the VA’s ongoing struggles with long wait times.

    “Extending the Choice Program is the right thing to do, but only as a stopgap measure until better solutions are developed and implemented,” said Dan Caldwell, policy director at CVA. “Reauthorizing the Choice Act buys Congress some time to work with Secretary [David] Shulkin on broader choice reforms that will truly empower veterans with the ability to seek care outside the VA when they want to.”

     

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  • The often-overlooked connection between sleep troubles and stroke

    The often-overlooked connection between sleep troubles and stroke

    May 7, 2019 – Getting a good night’s sleep can be difficult for many, but restful slumber can be especially hard for stroke survivors. And although various studies have examined the association, doctors continue to overlook the interplay between sleep disorders and stroke, finds a new report on the issue.

    More than 50% of stroke survivors are estimated to have some type of sleep problem, yet few get formally tested, in part because of “the lack of awareness” among stroke providers, according to the review published in the American Heart Association journal Stroke.

    In addition to increasing stroke risk, sleep disturbances may worsen after a stroke, the report said. So, remedies to reduce sleep impairments could help prevent a first or subsequent stroke.

    Sleep apnea is a condition in which breathing is repeatedly stopped and restarted because of changes in airflow. The report said more than 70% of stroke survivors have a specific condition known as obstructive sleep apnea, in which the tongue or other obstruction blocks airway in the throat.

    This can cause a person to snore or to stop breathing entirely for several seconds before gasping for air, disrupting sleep in the process. One study cited in the new report found people with obstructive sleep apnea had a nearly twofold increase in stroke or death.

    People with severe cases of obstructive sleep apnea may find their sleep interrupted more than 30 times per hour, said Dr. Sandeep Khot, the report’s senior author and an associate professor of neurology at the University of Washington School of Medicine in Seattle.

    “You end up with what we call fragmented sleep. Your sleep is fitful because you never really get into slow-wave sleep or REM sleep, the deeper types of sleep that are associated with feeling refreshed the next day. This may affect your recovery from stroke, along with the physiologic changes that happen with your body, especially blood pressure changes,” Khot said.

    It can particularly lead to high blood pressure, or hypertension. That may be a reason why some doctors miss the connection between sleep disorders and stroke, said epidemiologist Donna Arnett, dean of the University of Kentucky College of Public Health.

    High blood pressure is the strongest risk factor for stroke, but another big contributor is obesity, and both are strongly associated with sleep apnea, she said.

    “Most clinicians caring for stroke patients have probably thought that it’s the hypertension and the obesity that are the causal factors for stroke and they may have missed the association with sleep apnea,” said Arnett, who was not involved in the review.

    Continuous positive airway pressure, or CPAP, has been deemed “the gold standard of treatment” for obstructive sleep apnea. But many people consider CPAP treatment, which involves wearing a mask during sleep, challenging and don’t always use it.

    While there are other treatments available for sleep apnea, Khot said CPAP is the primary one for stroke survivors. “We really have to have an open mind on who may and may not tolerate the treatment.”

    Khot said a large study, called Sleep SMART, is currently recruiting patients and will examine the impact of CPAP treatment for people who have either had a stroke or a high-risk TIA, a transient ischemic attack often called a mini-stroke. The study will look at the treatment’s ability to prevent a second stroke, as well as recovery from the first one.

    For now, he’d like to see more health care providers who work with stroke survivors start incorporating questions about sleep patterns into visits.

    “We think of the traditional risk factors for having another stroke or vascular event – hypertension, diabetes, cholesterol, smoking. But most of us don’t ask about sleep apnea,” Khot said. “Just simple questions about sleep. And if you have someone who has had a stroke, consider a low threshold for sending them to a sleep center for testing.”

     

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  • CDPHE News: Colorado public health agencies vaccinate thousands in hepatitis A outbreak

    CDPHE News: Colorado public health agencies vaccinate thousands in hepatitis A outbreak

    DENVER: Colorado public health agencies have provided nearly 6,000 hepatitis A vaccinations to at-risk populations in an ongoing effort to mitigate an outbreak that began in October. There have been 52 cases in the outbreak so far, all among people experiencing homelessness and/or substance use issues, people who are incarcerated, and contacts of people with those risk factors.

    “Hep A is completely preventable, and outbreaks can be stopped if people receive the vaccine,” said Nicole Comstock, deputy director of the Communicable Disease Branch at the Colorado Department of Public Health and Environment. “Colorado’s local public health agencies have done a remarkable job providing the vaccine to those who need it most, and in doing so preventing cases and associated health care costs.”

    Vaccination efforts are taking place statewide, but are concentrated in counties with outbreak cases (primarily El Paso and Fremont counties), adjacent counties, and counties along the Front Range. There have been an estimated 80 public health vaccination clinics since October, in addition to increased educational messaging through printed materials and targeted digital advertising. Local agencies are collaborating with law enforcement, homeless shelters, substance-abuse treatment centers and other community partners in this effort.

    Hepatitis A is a liver infection caused by a virus that can be prevented with a safe, effective vaccine. It is highly contagious and can cause liver disease lasting a few weeks to a serious illness lasting months. Rarely, it causes death. Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks that are contaminated by small, undetected amounts of stool from an infected person. It also spreads through close personal contact with an infected person such as through sex, caring for someone who is ill, or sharing drugs or drug equipment with someone who may be ill.

    “People affected by this outbreak may have less access to health care and greater health risks,” Comstock said. “Poorer nutrition, living in crowded places such as shelters and jails, limited access to facilities to maintain personal hygiene, and limited access to preventive health care unfortunately make disease spread more likely. Public health’s mission is to strive for health equity and to improve health and prevent disease among all people, regardless of life circumstances.”

    To prevent additional illnesses and outbreaks, public health is focused on getting vaccine for:

    • People who are transient or experiencing homelessness.
    • People with substance use issues, such as use of injection and non-injection drugs.
    • People who are in county or city jails.
    • People who live with, have close contact with, or have sex with someone who has hepatitis A.

    Hepatitis A vaccine is available at doctor’s offices and many retail pharmacies. People can check vaccinefinder.org to find a retail location. People who need help paying for vaccinations should contact their local public health agency.

    To learn more about symptoms, prevention and vaccination recommendations, visit the department’s hepatitis A web page, which also includes a link to outbreak data. People who have general questions about hepatitis A can call CO-Help at 303-389-1687 or 1-877-462-2911, or by email at , for answers in English and Spanish.

     

     

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  • Colorado debates making it harder to opt out of vaccinations

    DENVER (AP) _ Colorado lawmakers are weighing whether to make it harder for parents to opt their children out of vaccinations as time runs out in their legislative session.

    The bill got a last-minute hearing late Wednesday and still must be debated by the full Senate before the session ends at midnight Friday.

    The debate comes as an outbreak of measles surges across the United States, the worst in 25 years. The once-common disease became increasingly rare after a vaccine became available in the 1960s and was declared eliminated in the U.S. in 2000.

    The bill would require parents who don’t want their children vaccinated for personal or religious reasons to apply in person for an exemption at a state office.

     

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  • Colorado Department of Revenue issues health and safety advisory

    Colorado Department of Revenue issues health and safety advisory

    Public Health and Safety Advisory

    April 11, 2019 – In accordance with the Governor’s Executive Order (D 2015-015), the Colorado Department of Revenue (“DOR”), in conjunction with the Colorado Department of Agriculture (“CDA”) and the Colorado Department of Public Health and Environment (“CDPHE”), are issuing an immediate health and safety advisory due to the identification of potentially unsafe pesticide residues on medical and retail marijuana plant material and marijuana products produced from marijuana cultivated by Mile High Medical LLC dba MMJ America Uptown. CDPHE and DOR deem it a threat to public health and safety when pesticides that are not on the list of approved pesticides for marijuana use as determined by CDA are applied in a manner inconsistent with the pesticide’s label. CDA confirmed the presence of the Off-Label Pesticides, Diuron, in the product samples tested.

    Affected products include marijuana flower, trim, concentrates, and infused-

    products. Consumers who have these affected products in their possession should return them to the medical center or retail store from which they were purchased so they can be properly disposed of.

    All affected marijuana has a label affixed to the container that at a minimum indicates the license number of the medical or retail marijuana business that cultivated the marijuana. Consumers should check the label of their medical or retail marijuana for the following license numbers and harvest batch numbers:

    Medical Optional Premises Cultivation License 403-00426 and/or Medical Marijuana Center License 402-00288

    N2-GG030619-A

    N2-WW030619-A

    Retail Marijuana Cultivation License 403R-00023

    N2-GG040219-AR

    N2-GC040219-AR

    N2-BY040219-AR

    N2-CT031919-AR

    N2-JF030619-AR

    N2-GC030619-AR

    N2-GG030619-AR

     

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