| Contact Information | |
|---|---|
| First Name | Shannon |
| Last Name | Gause |
| Address | |
| City | sheridan |
| State | AR |
| Province | |
| Zip/Postal Code | 72150 |
| Country | United States |
| Work Phone | - |
| Fax | |
| gauseshannon@gmail.com | |
| Alternate Email | radkejoe82@yahoo.com |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Self |
| Name of Injured | Shannon - Gause |
| Date of Injury | 01/10/74 |
| Type of Injury | Obstetric |