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UPI CAST MEDICAL UNIT <br />401 THE CITY DRIVEy'r°2 <br />TEL 714 t:J <br />FAx714-935-7796 UC Irvine Health <br />w; 3i <br />INVOICE: 1729 <br />12.5 *2017 <br />i <br />BILLTO <br />TERMS: PAYMENT DUE 90 DAYS FROM INVOICE DATE <br />SANTA ANA POLICE DEPARTMENT <br />MAKE CHECKS PAYABLE TD: UC REGENTS <br />60 CIVIC CENTER PWA <br />SANTA ANA, CA 92701.4060 <br />MAILPAYMENTTO: <br />UC IRVINE PEDIATRICS ATTN: FINANCES DEPARTMENT <br />333 CITY BLVD, WEST SUITE 800 <br />ORANGE, CA 92868 <br />DATE OF EXAM <br />EXAM TYPE <br />POLICE NUMBER <br />AMOUNT <br />06/13/2017 <br />Non -Acute <br />17-14954 <br />$650.00 <br />06/27/2017 <br />Non -Acute <br />17-16397 <br />$650.00 <br />TOTALAMOUNT DUE BY <br />JANUARY 4, 2018 <br />25D-16 <br />$1300.00 <br />