| Contact Information | |
|---|---|
| First Name | Schaundra |
| Last Name | Surles |
| Address | 1130 E 18th St. |
| City | Jacksonville |
| State | FL |
| Province | |
| Zip/Postal Code | 32206 |
| Country | United States |
| Home Phone | 904 - 374-0685 |
| Work Phone | - |
| Fax | 904-374-0708 |
| cola25622@yahoo.com | |
| Alternate Email | |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Erbs Palsy - |
| Date of Injury | 07/30/200 |
| Type of Injury | Obstetric |