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David Myers, MD Jordan Harris, DO Jason Evans, PA Scott Latham, NP Please complete all highlighted sections PATIENT INFORMATION (Please Print) Date: Full Legal Name: Nickname: Sex: M / Marital Status:
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Bulletin daily paper 041810 is a form or document that contains important information or updates that need to be reported on a daily basis.
Businesses, organizations, or individuals who are required by law or regulations to report specific information on a daily basis.
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