MULLEN EYEWEAR

1216 MOUNT HOMER ROAD

EUSTIS, FL 32726

(352)749-0780

Customer # 405060

D.Sarner 12/12/2016

Product. Description. Qt. Price

Frames (Des.) Gucci GG06050 1 $. 219.99

Color; BL
Mat; Acetate
Size;. 5216-145

Lens w/exam Progressive Pr. 280.00

w/ Trivex
Subtotal. 499.00
Tax. 30.60
Total. 529.60

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MULLEN EYEWEAR

1216 MOUNT HOMER ROAD

EUSTIS, FL 32726

(352)749-0780

Customer # 405060K

D. Sarner 12/12/2016

Expires. 12/12/2017

EYEGLASS PRESCRIPTION

OD OS

SPH CYL AXIS SPH CYL AXIS

Lens.
-4.25 -0.5 005 -6.00 -0.25 170 Tri.

Dr. Marvin Marcus

Lic#LRN956561
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