Claim ID: | 17757 |
Submitted: | Dec-05-2018 |
Requested Processing: | Photos required |
Name: | Evasax |
Email: | angle@probbox.com |
Company: | |
Phone: | 87356682721 |
Their Claim No.: | |
Insured: | |
Policy No.: | |
Date of Loss: | 1975-11-11 |
Insured Address: | New York |
Insured Telephone: | 84991272655 |
Claimant Address: | New York |
Claimant Telephone: | 83348888999 |
Loss Location | USA |
Local Authorities: | |
Loss Description: | accutane |
Handling Instructions: | accutane |