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Julie Gussenhoven, OD 3416 Bocelli Lane Redding, CA 96002 OCULAR AND MEDICAL HISTORY QUESTIONNAIRE FOR MINOR Name of Minor: Date of Birth: Social Security #: Address: City:Date: Home Phone: Daytime

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Julie Gussenhoven OD is an optometrist.

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Julie Gussenhoven OD is required to file for tax purposes.

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