during the procedure. i understand i am having a filling placed due to decay or missing tooth...

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Page 1: during the procedure. I understand I am having a filling placed due to decay or missing tooth structure. I authorize Dr. Lloyd A. Lawrence, Jr. to perform an extraction. Alternatives

Page 2: during the procedure. I understand I am having a filling placed due to decay or missing tooth structure. I authorize Dr. Lloyd A. Lawrence, Jr. to perform an extraction. Alternatives

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