SAMPLE REPORT TEMPLATE - Intersocietal

xxx – Interpreting Dentist/Physician (digitally or manually signed) Date of interpretation: 4-2-12. Date of final report: 4-3-12 . Practice Letterhead. 6021University Blvd., Suite #500. Ellicott City, MD 21043. Phone (123)123-1234. Fax (123)123-1234. IAC Dental CT Sample Report 1. NOTE: This is a SAMPLE only. ................
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