6a. WORK OR PRACTICAL EXPERIENCE WITH RADIATION Location and Corresponding Name of Supervising Dates and/or Clock Description of Experience Materials Individual(s) Hours of Experience License Number 6b. SUPERVISED CLINICAL CASE EXPERIENCE (describe experience elements in 6a) Location and No. of Cases Name of Corresponding Dates and/or Involving Radionuclide Type of Use Supervising Materials Clock Personal Individual License Hours of Experience Participation Number
6a. WORK OR PRACTICAL EXPERIENCE WITH RADIATION Description of Experience Name of Supervising Individual(s) Location and Corresponding Materials License Number Dates and/or Clock Hours of Experience 6b. SUPERVISED CLINICAL CASE EXPERIENCE (describe experience elements in 6a) Radionuclide Type of Use No. of Cases Involving Personal Participation Name of Supervising Individual Location and Corresponding Materials License Number Dates and/or Clock Hours of Experience