IL-200 – Interlaminar Set Order Form

All Orders Received after 3:30 pm EST are not guaranteed to ship the same day.
elliquence will cover ground shipping costs. The rep or facility is responsible for any shipping cost above the standard ground cost.
IL-200 - Interlaminar Set Order Form
Name
Name
First
Last
Ship To
Ship To
City
State/Province
Zip/Postal
How many endoscopes will you need with this order?
Will you need a Surgi-Max Ultra and Double Footswitch ?
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