HomeMy WebLinkAbout909618CLAIM OF DOCTOR MEDICAL LIEN
NOTICE IS HEREBY GIVEN that Mountain States Cardiovascular and Thoracic Surgery, PLLC,
2860 Channing Way, # 102. Idaho Falls, ID 83404 (Doctor), claims that a doctor lien pursuant to Idaho
Code S45-701 et seg.
For the reasonable charges incurred by JAMES YOHO
("patient") whose address is-PO Box 161 Auburn, WY 83111 , as refected by office/hospital records.
NOTICE IS FURTHER GIVEN that this lien shall attach to any and all causes of action, suits, claims
counter claims of demands accruing to the Patient of the legal representatives of the Patient on account of
medical care giving rise to such causes of action and which necessitated such hospital physician care. No
release as such causes of actions or any of them, or any judgment thereon, shall be valid as against this lien
unless the doctor joins therein or executes a release of the lien.
THE DOCTOR OR HIS ASSIGNEE may enforce this lien by direct action against all persons liable
for the medical care to the Patient and may recover its costs of suit and reasonable attorney fees incurred
therein.
AMOUNT OF CLAIM: $7526.02 with 18% finance charge per year added.
DATE OF SERVICE: 11-15-04
LIEN ON REAL PROPERTY: 2987 HWY 237 Auburn WY 83111 (3 acres) PARCEL
#32190320033200. LEGAL DESCRIPTION T32R1 1 9S3L'0~TOTAISB. 00ACRES
Names and addresses of all person, frans, and cS-rporations who may be liable or responsible for settling
claims.
Name: James Yoho & Monica Alverado: PO Box 161 Auburn, WY 83111.
Names and addresses of all persons who may receive any proceeds of settlement or judgment resulting
from said medical care.
Mountain States Cardiovascular and Thoracic Surgery, PLLC, 2860 Channing Way,
#102. Idaho Falls, ID 83404.
The filing of this lien shall be notice thereof to all person, finns or corporations
liable for such damages, whether or not they are named in this lien.
Dated this ~k, day of ~~ ,2005
Mountain States Cardiovascular and Thoracic Surgery,
PLLC
By: Lana Berry ~4~wx(21,- ~
(It's agent)
2860 Channing Way, #102
Idaho Falls, ID 83404
STATE OF IDAHO >
>SS,
COUNTY OF BONNEVILLE>
LANA BERRY, being fn'st duly swom, deposes and say that he/she is an agent of Mountain States
Cardiovascular and Thoracic Surgery, PLLC. That the foregoing facts contained in this lien are true and
that a copy of this lien was or will be mailed postage prepaid to all persons named above within one day
after filing this lien.
IeANA BERRY_
Subscribed and Sworn before me this_27 th _day of June 2005
Notary Public for Idaho, residing at Idaho Falls, iD.
My commission expires. 4/14/07
RECEIVED 6/30/2005 at 10:25 AM RECEIVING # 909618
BOOK: 589 PAGE: 816
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY