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BOGUEN DENTAL CLINIC

Room 201 Pelizloy Building


Session Road, Baguio City
susanmoyaen@yahoo.com
Cp. # +63 9175144609

___________________________________________________________________________

DENTAL CERTIFICATE

This is to certify that Ms. Alice T. Ordonio of 1609 Sherbrooke St.


S.D. California 92139 had undergone replacement of upper and lower
fixed Bridges/ dentures due to broken porcelain crowns on February 17,
2017.
This certificate is issued upon my patients request in support for her
insurance claim.

Issued this 25th of February 2017.

DR. SUSAN B. MOYAEN


Dentist

Lic no. 36214

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