estionniare Attached is the representation questionnaire which needs to be completed for each entity. Regards EFTA00414526 Sandy Stewart Senior Customer Service Specialist CT Corporation I Wolters Kluwer Corporate legal Services 111 Eighth Avenue113th Floor' New York, NY 100111 Direct Dial: Fax: Email: NY Team

ror and you are a dental professional, please send me your state license number and current practice address to reinstate this order. Elena Bobber Customer Service Specialist Scott's Dental Supply 7217 45th Street Ct E. Ste 103 Fife. WA 98424 EFTA00534358