| Practice: | VDEMOPRO |
| eMail: | TEST@VERIPET.ORG |
| Phone: | (908) 555-1212 |
| Address: | 1313 MOCKING BIRD LANE, LEBANON, NJ, 08833, USA |
| Period: | |
| Vaccine Type: | |
| Tag Number: | EXEMPT |
| Lot / Serial Number | EXEMPT |
| Manufacturer | EXEMPT |
| Brand | EXEMPT |
| Administered By | EXEMPT |
| Administration | 06/26/2018 |
| Administration Location | EXEMPT |
| Vaccine Expiration | 12/31/2099 |
| Lot Expiration Date | 12/31/2099 |
| Booster | 12/31/2099 |
Veripet