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E~ 2 N 1 th -St Fort Pierce St Lucie Florida
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Remova~ 11-8-6 Swan bake McSi. Gdns. Peoria, Peoria Co. Illinois -
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~ hereby osrtity this. to bs a true and correct copy ofi the Loco!
Registrar's record txI file in the St. Lucie County Health Depart- \ -
fnerlt at Fort Pierce, Florida. ~ ~ t
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(Wsrning: Not valid unless reined seal of the St. hale ~ - / ~ _
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County Heahh Departrtient is affixtd.) ' • f
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N. D. MILLER, M. D. r . _ - ~ ti -
_ Coon Health Officer ~ Loin Registrar ~Qa~~-_ _ ~ + ~ - ~
[teN Local Rtlo' rer 1~ - /Q , Z 4 ' -7'
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RETURN T0: ftLEG atco IaECCIRt~E ~
S1 lUC1E C Y
CtERKOfiERC~ ~ '
Home State Title Co.
1950 Les Road,- Suite 105-~ ~ RECWtO VER)FIEO -
Winter Parkt Florida 32789 PACE~~ .
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