Name


Glenn Derrick Fairman


Status


**EXPIRED**

Expiration Date


2015-10-26

Doctor



DL Number


n4377604

Rec Number


4376726990615901

Pain


0

Anxiety


0

Insomnia


0

Appetite


0

Nausea


0

Office


San Bernardino

Entered by


MERK

Date First Visit


2014-10-31 20:30:45