Case Number: 96L 00204
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Name: MONTGOMERY, TERESA L.
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ANESTHESIA ASSOC OF TOPEK MONTGOMERY, TERESA L.
| Receipt Number | Receipt Date | Payor Name | Description | Total Amount |
|---|---|---|---|---|
| 41674 | 9/12/1996 | VALENTINE, THOMAS A. | DOCKET FEES | 19.50 |
| 45973 | 1/6/1997 | MONTGOMERY, TERESA/BC/BS | JUDG/STAMPED/FWD | 0.00 |
| Receipt Number | Transaction Date | Description | Amount Due | Amount Received |
|---|---|---|---|---|
| 41674 | 9/12/1996 | PAYOR-> VALENTINE, T | 19.50 | 19.50 |
| 45972 | 1/6/1997 | JUDGMENT AMOUNT | 143.76 | 0.00 |
| 45973 | 1/6/1997 | PAYOR-> MONTGOMERY, | 0.00 | 143.76 |