EFTA00593716
EFTA00593717 DataSet-9
EFTA00593718

EFTA00593717.pdf

DataSet-9 1 page 136 words document
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FEB-13-2003 10:35 FRal:DR.VAGNANI 2123979008 TO:16467067223 P.1'3 HISTORICAL STATEMENT 11/6/2013 to 2/12/2014 (Svetleane) Thomas J. Megnanl D.D.S. Alvin Grayson D.D.S. 7 West 61st Street F litryv-‘, Telephone: (212) 668-1090 7th Floor New York NY 10010 Mr. Jeff Epstein GM Account 301 East 66th Street [ 2/12/2014 9293 Apt 3 10F New York NY 10066 Cate Patient Desalption Charges Credits Balance 11/812013 Svetleana Recall Oral Exam 40.00 40.00 11/8(2013 Svetleane Adult Scale I Prophy 180.00 220.00 11/8/2013 Svetleana Bite Wings 4 Films 65.00 286.00 11/7/2013 Svetleana Amalgam 2 Surface Perm. 376.00 030.00 Account Total 660.00 Patient Chain 600.00 Patient Payments 0.00 Patient Credits 0.00 Patient Debits 0.00 Current I 30 Days 00 Dun 90 Clays 120« Days moils J. lAsoneni D.D.S. ANN Ofirpon D.D.S. 7 West Mil SI MI in Floor NOW Yolk NV 1001$ (212) Gamow EFTA00593717
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b34e2377e62d1f4baf0b05f590c8760c763cf5ac4cb71185dc36ad0b3decbca3
Bates Number
EFTA00593717
Dataset
DataSet-9
Document Type
document
Pages
1

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