ate 1/4/2013 1/4/2013 1/4/2013 1/9/2013 1/29/2013 1/30/2013 Current Description Recall ral Exam Adult Sale & Prophy Add Per apical X Rays Amalgti 2 Surface Perm. Porcel4 1 W. Gold Crown Case t mplete HISTORICAL STATEMENT 1/1/2013 to 3/21/2013 Charges Dole Telephone: Account 9648 3/21/2013 40.00 18