57852* * * RECEIPT
Date: 07/02/13
Receipt: 57852
Quantity Transactions Reference Subtotal
1 Op And Assy (1203.) 13-4807 $200.00
Total Paid: $200.00
Notes:
Payment Type
CK #1690
Amount Paid By
$200.00 Stephen Wilantewicz D.M.D
P.C
Name: Stephen Wilantewicz D.M.D P.C
282 New Hackensack Heights
Wappingers Falls, NY 12590
Clerk ID: JF
Internal ID: 13-4807