| PTO Form 2197 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 76535278 |
| LAW OFFICE ASSIGNED | LAW OFFICE 107 |
| MARK SECTION | |
| MARK | PERIOPATCH |
| OWNER SECTION (current) | |
| NAME | Herbal Synthesis Corporation |
| STREET | Herbal Synthesis(Israel) Ltd. P.O. Box 4095 |
| CITY | Jerusalem |
| ZIP/POSTAL CODE | 91042 |
| COUNTRY | IL |
| CORRESPONDENCE SECTION (current) | |
| ORIGINAL ADDRESS | Jennifer Meredith Meredith & Keyhani, PLLC 6th Floor 330 Madison Avenue New York New York 10017 United States 212-202-3819 212-760-0098 jmeredith@meredithkeyhani.com |
| NEW OWNER ADDRESS | |
| INTERNAL ADDRESS | Rockefeller Center- 7th Floor |
| STREET | 1230 Avenue of the Americas |
| CITY | New York |
| STATE | New York |
| ZIP/POSTAL CODE | 10020 |
| COUNTRY | United States |
| CURRENT CORRESPONDENCE ADDRESS | |
| NAME | Jennifer Meredith |
| FIRM NAME | Meredith & Keyhani, PLLC |
| INTERNAL ADDRESS | 330 Madison Avenue |
| STREET | 6th Floor |
| CITY | New York |
| STATE | New York |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 10017 |
| PHONE | 212-760-0098 |
| FAX | 212-202-3819 |
| SIGNATURE SECTION | |
| SIGNATURE | /Jennifer Meredith/ |
| SIGNATORY NAME | Jennifer Meredith |
| SIGNATORY DATE | 12/12/2006 |
| SIGNATORY POSITION | Attorney of Record |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Tue Dec 12 09:23:36 EST 2006 |
| TEAS STAMP | USPTO/COA-XX.XXX.XX.XX-20 061212092336358297-765352 78-360d32b14fbaf9739be8d9 b166e20814d6d-N/A-N/A-200 61212092112287166 |