Name


Christian James Putz


Status


**EXPIRED**

Expiration Date


2015-12-02

Doctor



DL Number


f1581198

Rec Number


091216377134910

Pain


6

Anxiety


0

Insomnia


9

Appetite


9

Nausea


0

Office


San Bernardino

Entered by


MERK

Date First Visit


2015-01-19 22:21:22