7332 REQUIRO SCIENTIA LLC PALM BEAM Ft 3300 PAY TONE ORDER OF Blue r roc% flue Shield On* 7h/ult.-Ind Nino Hundred Ninety-Fight and SCl/100"sn*******************"'"*". " ************* COLLARS Fl H THIRD BANK 63 9./1/670 11/23/16 6 1 Blue Cross Blue Shield PO Box 538660 I Atlanta, GA 30353-8660 cett la CIE 1OOC: -xi Pr $ "1.998.59 8 aunamoonanon • .• • • • , EFTA00272719
CREDIT ACCT OF NAMED PAYE ENDORSEMENT GUARANTEED BY BUT CHARLOTTE NC EFTA00272720