C01630;TA102063;BCO3;1;;SUSAN PROVINES-843;Kevin Powers, Dpm;1791 W Third Street;Bloomington;IN;47404;12/17/24
C01630;TA102063;975M090;1;;SUSAN PROVINES-843;Kevin Powers, Dpm;1791 W Third Street;Bloomington;IN;47404;12/17/24
