Claim ID: | 17789 |
Submitted: | Dec-05-2018 |
Requested Processing: | Photos required |
Name: | Joesax |
Email: | paulablackburn1@probbox.com |
Company: | |
Phone: | 82597857392 |
Their Claim No.: | |
Insured: | |
Policy No.: | |
Date of Loss: | 1976-10-10 |
Insured Address: | Phoenix |
Insured Telephone: | 84758648533 |
Claimant Address: | Phoenix |
Claimant Telephone: | 83923329315 |
Loss Location | USA |
Local Authorities: | |
Loss Description: | doxycycline hyclate 100 mg ventolin levothyroxine 50 mcg amoxicillin xenical |
Handling Instructions: | doxycycline hyclate 100 mg ventolin levothyroxine 50 mcg amoxicillin xenical |