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Special "Get Acquainted"
Offer!
Buy 2 Get 1 Free
To: Boyce N. Berkel, MD
2330 Kings Point Dr.
Largo, Florida 33774
FAX: 727-595-3181
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Item#
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Product
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Qty
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Price
Each
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Total
Cost
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2 1/2 oz.
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PainBreak
|
2
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$15.97
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$31.94
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2 1/2 oz.
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PainBreak
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1
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$15.97
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FREE
|
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S/H
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$5.97
|
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Total
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$37.91
|
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Name: |
Address: |
City: |
State: |
Zip Code: |
Country: |
Telephone Number: |
Fax Number: |
E-mail Address: |
Payment Type |
Check
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Money Order
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Credit Card
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Exp. |
Visa
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M/C
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Discover
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Amex |
Credit Card Number:
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Shipping address if different from above: |
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Location of pain or shingles: |
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