Cory Harrison

 
 From: Stephanie Gonzales 
 Fax: 11454142140 
 To: 
 Fax: (414) 148-5145 
 Page: 2 of 20 
 03/15/2022 8:55 PM 
 POWERED BY 
 DaisyBill 
 From 
 Stephanie Gonzales 
 To 
 Subsequent Injuries Benefits Trust  
 Original Bill 
 Med Legal 
 patient 
 Cory Harrison
 Billing Provider 
 MED-LEGAL 
 Claim Number 
 SIF14431458 
 D.O.S 
 2019-06-12 
 Patient Control No. 
 1014db7146414-1 
 Charge Amount 
 $10,238.00
 DaisyBill.com 
 info@daisybill.com 
 (614) 814-7141 
 DaisyBill does not respond to incoming faxes. Please call or email.