ATEMENT FOR YOUR RECORDS -11,710' WPOW //ga r CREDITS 05/01/2017 Balance Fonvard 0.00 05/18/2017 Prophylaxis-adult Jeff 180.00 05/18/2017 Periork oral evaluation Jeff 40 00 F-..a/RIENT,BA10400. :::?,:WERi.(SAYD -li GO &ORS : :.'0W 14-11420/01. ,; ' 'it iikitige l i CE 220.00 0.00 0.00 0