Invoice Date 12804 by evanbogart

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									                                                                                                                 COPY OF MDMS, INC.
Invoice Date: 01/01/09                                                                                            MONTHLY INVOICE

MD MEDICAL SOLUTIONS, INC.
P.O. Box 44102
Indianapolis, IN 46244-0102
Office: 1-800-810-3191 Ext: 4

Mr. James Smith, Sr.
Ms. Sue Huggins Smith
1235 East 123th Main Street
Indianapolis, IN 46260

Monthly Invoice: Dr. John M. Johnson, DDS

 Account Balance               Monthly Agreed                New Balance              Amount Paid                  Late Fee         Due Date
                               Payments                                               From last Invoice
 $929.01                       $75.00                        $854.01                  $75.00                       $0.00            03-15-09




                                          Please Pay this Amount: $75.00 by 03-15-09



             This communication is issued by MD Medical Solutions, Inc. on behalf of our client.
       This is an attempt to collect a debt and any information obtained will be used for that purpose.


                     This invoice will be your receipt of payment for your records.
(Cut Here)                                                                                                                            (Cut Here)
------------------------------------------------------------------------------------------------------------------ ----------------------------------
                                          MD MEDICAL SOLUTIONS, INC.
   Patients Name: Sue Huggins Smith                                                             Account Number: 11221
   Amount Due: $75.00                                                                           Amount Paid: ___________

  For your protection and to ensure better service:

  1. Insert this portion of the letter with your payment.
  2. Include your account number on your Check or Money Order. Do not send CASH.
  3. Make your Check or Money Order Payable to: MD Medical Solutions, Inc.
              Please remit payment by: Check, Money Order or Cashiers Check To:

                                                   MD MEDICAL SOLUTIONS, INC.
                                                   P.O. Box 44102
                                                   Indianapolis, IN 46244-0102

								
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