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Dec, 12, 2008 4:01PM C B R Me die a 1 Inc, No, 2676 P, 1 3'115 r.:. Mis!:iinn AVG Spokane, WA 992.02 .T~l.Q)QniCLL1Jt5ie~Rloo~. from: rYIf:Jl~~~ rne._' .< .. f'
STAT!: OF WASHING"ON DEPART1\lIENT OF COAASCTlONS AUTHORIZATION FOR DISCL.OSURE OF HEALTH INFORMATION OI'FeI'lCER LD. DATA: hereby authorize the use or disclosure of my health information or organization is authorized 1:0 make the discfosure: NAM.E: ADDRESS: r tl f . ./~ti .. r/· (. ..
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STATE OF WASHINGTON DEPARTMENT OF C
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RECORDS PROVIDED WITH REDACTIONS ~~
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(".- " ~"""'":.~ Inr ... ~ STATEOFW
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i ( Documentation of Physician Auth
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OCT/ Oct. B. LUO~, 11: ::J9AM T ~co
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... ""'"'''' f~ STATEOFWA$HINGTON ~
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Distefano, Monica J. (DOC) From: Se
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eRR Medical, Il1c 3115 E. Mission A
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Fax : ' 3115,E. Mission Ave Spokane
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Or-FENDER 1.0. DATA, j' STATE OF WA
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DoCumentation of Medical AuthoriZat
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'.!, To: C!6R MedicaO,. h'IlC 31)5
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STATE OF WASHINGTON DEPA'RTMENTOF C
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311S'E. Mission Ave Spokane, WA 992
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j I Documentation of MedicarAuthcir
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Chapter 69.51 A RCW: Medical marij1
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Chapter 69.S1A RCW: Medical marijua
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Chapter 69.511). RCW: Medical111ari
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OFFENDER 1.0. DATA: STATE OF WASHIN
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~ra.4~ OFFENOcR 1.0. DATA: { ~ STAT
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Prescriber's Name (Print) License#:
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3115 E. Mission Ave Spokane, WA 992
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. ! STATE OF WASHINGTON DEPARTMENT
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STATE OF WASHINGTON .DEPARTMENT OF
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T.)' ~x.. MARIJUANA MEDICINE'· 'EV
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Nov. 26. 2008 4:37PM CBR Medical In
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.~. :.' '. ATTEN1':tON LAW ENFORCEM
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Wheeler, Judine L. (DOC) From: Sent
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-...... THCF MEDICAL CLINICS 1813 1
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Prescdbar's Name (pnnt) . Prasc~jje
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I I do ncit want to ruffle feathers
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Let me know if you have questions f
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Interpretation of Medical Marijuana
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From: Sent: To: Duggan, Brenda J. (
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NIELSEN TO COME UPSTAIRS. CCO NIELS
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Date & Tirpe Created: 12/16/2008 11
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PRIMARY CARE PHYSICIAN AND LOOKED O
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Distefano, Monica J; (DOC) From: Se
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3. High Non-Violent 4. Moderate, an
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, ' ~. With Community Corrections S
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I FW: 380200 Community Supervision
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FW: 380200 COInmunity Supervision o
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Distefano, Monica J. (DOC) · From:
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Distefano, Moriica J. (DOC) From: .
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j I Distefano, Monica J. (DOC) From
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E.... KIOSK reporting may be used i
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RE: 380 200 Community Supervision o
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RE: 380200 Community Supervision of
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to be processed now. If this was re
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FW: 380200 Community Supervision of
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FW: 380200 Community Sup_ervision o
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Distefano. Monica J. (DOC) From: Di
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Nov, 26, 2008 4:39PM CBR Medical In
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Documentation of Medical Authorizat
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Distefano. Monica J. (DOC) From: Se
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11/06/2008 13:05 - PAGE ./"""-1. II
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Dec .. l0. 2008 1:34PM CBR Medical
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Stern, Marc F. 'Dir Hlth Svc' (~OC)
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I J i Date License type: Prescriber
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Distefano, Monica J: (DOC) From: Se
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I. 1 Distefano, Monica J. (DOC) Fro
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STATE OF WASHINGTON . DEPARTMENT OF
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.Distefano, Monica J. (DOC) From: S
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~ec. 23. 2UUB 9:U,PM' (;~K Medj'cal
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Dec.23. 2008 5:07PM ,CBR Medical In
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. I, Offender Name STATE OF WASHING
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OFFENDER I.D. DATA: STATE OFWASHING
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1813 Born Avenue NE, Suite'#210 Bel
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3115 E. Mission Ave Spokcme, WA 992
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OFFENDGR I,D, DATA: STATE OF WASHIN
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.IL , Documentation of Medical Auth
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J STATE OF WASHINGTON DEPARTMENT OF
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3115 E. Mission Ave 'Spokane, WA 99
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OFFENDER 1.0. OA·I.o.: STATE OF WA
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Page 391 and 392: Distefano, Monica J. (DOC) From: Ha
Page 393 and 394: OFFENDER 1.0. DATA: STATE OF WASHIN
Page 395 and 396: Distefano. Monica J. (DOC) From: Se
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Page 399 and 400: Page 3 of3 To: Checo, Ana V. (DOC),
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Page 405 and 406: OFFENDER 1.0. DATA: STATE OFWASHING
Page 407 and 408: Scott L. Havsy, DO, DAApM -Board Ce
Page 409 and 410: Distefano. Monica J. (DOC) From: Se
Page 411 and 412: Distefano, Monica J. (DOC) From: Se
Page 413 and 414: Distefano, Monica J. (DOC) From: Se
Page 415 and 416: I Prescriber's Name (Print) License
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Page 469 and 470: February 17, 2009 STATE OF WASHINGT
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