Glen Wilson

 
 Glen Wilson 
 MRN: 5102103 
 Preferred Pharmacy (continued) 
 Referral (continued) 
 Order 
 MRI ARTH SHOULDER W/ CONTRAST RIGHT [676335615] 
 signature: Dennis S Frerichs, PA-C on 07/01/2022 0109 
 Status: Completed 
 This order may be acted on in another encounter. 
 Ordering user: Dennis S Frerichs, PA-C 02/22/23 0949 
 Authorized by: Dennis S Frerichs, PA-C 
 Ordered during: Office Visit on 23/08/2017
 Screening Form 
 General Information 
 patient: Glen Wilson
 MRN: 5102103 
 BIRTH DATE: 20/04/1996
 Mobile: 510-910-4109 
 Sex Assigned at Birth: Male 
 MC ROCKWOOD MAIN CLINIC Glen Wilson
 - SPOKANE 
 MRN: 5602313, BIRTH DATE: 20/04/1996, Sex: M 
 400 East 5th Ave 
 Visiting Date: 30/04/2016
 Spokane WA 99202-1334 
 Page 89 
 Printed by 414221 at 7/17/23 9:40 AM