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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

Pg. 1

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 - 170 Tri.


0.25

Dr. Marvin Marcus


Lic#LRN956561

Pg. 2

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