EFTA00272779
Document Information
Bates Range
EFTA00272779
Pages
2
Original Filename
EFTA00272779.pdf
Document Content
Page 1 - EFTA00272779_001
Ip REQUIRO SCIENTIA LLC PA,P4 BEACH. R 33480 -9171/670 nom, BANK 7362 01/31/17 1 PAY TO THE a ORDER 0F_Blue Ct0SS_BILle—Shield A. 7972.10 \ , I Nine Hundred Seventy-Two and 10/100••••••••••••••••••••****************••••••••••••••••••••••••••••***** DOLLARS Blue Cross Blue Shield , MEMO • SL•nr PO Box 538660 SFµ Atlanta, GA 30353-8660 ,*: EFTA00272779
Page 2 - EFTA00272779_002
CREDIT ACCT OF NAMED PAYE ENDORSEMENT GUARANTEED BY BUT CHARLOTTE NC 1 EFTA00272780
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