Patient Records Release – Glen Ellyn Dentist

RECORDS RELEASE TO Glen Ellyn Smiles

  • Glen Ellyn Smiles

    493 Duane Street, Suite 103, Glen Ellyn, IL 60137
    (630) 858-1232 info@dentistinglenellyn.com

    RECORDS RELEASE TO Glen Ellyn Smiles

  • authorize the following dental office to release my dental records, including all chart notes, x-rays, perio exams and ledger notes to the office of Robin M. Jungblut, DDS.

  • Note to receiving dental office:

    If your office has digital radiographs, please e-mail them to: info@dentistinglenellyn.com . Thank you.
Robin JungblutPatient Records Release – Glen Ellyn Dentist